Leïomyosarcome de la prostate: Neoplasie rare

The prostatic leïomyosarcoma is a very uncommon tumor of the adult. It is often diagnosed to an advanced stage, because of the clinical and radiological non specificity. Its prognosis is very dark.The objective of our study is to illustrate the important role of the imagering, represented by the CT and especially the MRI in the balance of extension and the post-therapeutic follow-up of this tumor.We report a 49 years old patient's observation, allowed for unrests mictionnels evolving since 6 months in a context of change of the general state. To the clinical exam, the prostate was increased of volume and nodular. A radiological balance made of US, CT and abdomino-pelvic MRI has been achieved. It showed an heterogeneous prostate, infiltrating the grease of neighborhood and the ureteral meats, with important bilateral urétéro-hydronephrosis of uphill. One also noted the presence of suspected hepatic nodules. A trans-perineal prostatic biopsy has been achieved, concluded to a prostatic leïomyosarcoma. Because of the bad general state and the importance of the local extension and from afar of the prostatic tumor, a trans-ureteral resection has been achieved, associated to a chemotherapy. The evolving have been marked by the patient's death after his second cure of chemotherapy.The CT and especially the MRI had a primordial role in the balance of local extension and from afar of the prostatic léïomyosarcoma and the only means to affirm the diagnosis is the histology completed by an immuno-histochimical study. Their therapeutic handling is not codified at the present time and their prognosis remained very dark.