Abstract

João Paulo Martins de Carvalho, João Pedro Gaio Meirelles Rozado, Alexandre Vinícius Guimarães Araújo, Paulo Cesar Nanci de Carvalho

The symptoms of prostate hyperplasia, such as tenesmus, nocturia, and urinary retention are common in elderly men. A healthy male patient, 92 years old, in urologic follow up for benign prostatic hyperplasia culminated to acute urinary retention and indication of a retropubic prostatectomy. Exams documented a prostate of 180 grams, PSA 2.45 ng/dl. A digital rectal exam documented grade IV prostate with an adenomatous and fiber elastic aspect, without nodules. Surgery and thorough immunohistochemical studies of the specimen were performed, and primary GIST (gastrointestinal stromal tumor) of the prostate was confirmed. Posterior staging did not document another focus of the illness, and a complete resection of the primary mass was performed. The patient and his family were offered all the treatment options and opted for an exclusive clinical follow up, without adjuvant chemotherapy or radiotherapy. This decision was made based upon all the collateral effects that chemotherapy and radiotherapy would produce with no gain to the patient’s quality of life. In patients with localized disease, contingent on individual analysis of performance status as well as social aspects, exclusive clinical follow up can be offered according to their life expectancy.