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      Leiomyoma of the Prostate Treated via Holmium Laser Enucleation: A Case Report and Literature Review

      case-report
      1 , , 1 , 1 , 1 , 1
      ,
      Cureus
      Cureus
      enlarged prostate, surgical morcellation, urethral leiomyoma, holmium: yag laser, dysuria

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          Abstract

          Leiomyoma is a rare tumor that arises from mesenchymal cells, with few reported cases of treatment using holmium laser enucleation of the prostate. A 74-year-old man with dysuria had a mass near the bladder neck in magnetic resonance imaging; this entity was suspected to be a leiomyoma. The patient underwent holmium laser enucleation of the prostate and one lobe was removed. However, the mass was firm and morcellation was difficult to break into small pieces. Therefore, it was fragmented via trans-urethral resection and removed with a curette. The postoperative course was favorable, with a positive clinical outcome. This case highlights the efficacy of holmium laser enucleation of the prostate in the management of prostatic leiomyoma and emphasizes its importance as a viable treatment option.

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          Most cited references8

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          Spindle cell lesions of the adult prostate.

          Prostatic spindle cell lesions are diagnostically challenging and encompass a broad array of benign and malignant processes. A subset of these lesions arises only within the prostate and generally represents entities that originate from the prostate epithelium or stroma, such as sclerosing adenosis, sarcomatoid carcinoma, stromal tumors of uncertain malignant potential (STUMP), and stromal sarcoma. Another subset of spindle cell tumors that involve the prostate are also found at other sites and include solitary fibrous tumor, leiomyosarcoma, and neural lesions among others. Finally, tumors may secondarily involve the prostate yet present as primary prostatic processes, as is evident with several cases of gastrointestinal stromal tumors (GIST). The utility of ancillary studies, including immunohistochemistry, is often limited and the main criteria for diagnosis are the morphologic findings by routine H&E stain. This review addresses the various entities that may present as spindle cell tumors within the adult prostate and discusses the functional aspects of the differential diagnosis of these lesions.
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            Anteroposterior dissection HoLEP: a modification to prevent transient stress urinary incontinence.

            The prevalence of transient stress urinary incontinence (SUI) after HoLEP has been reported to be as high as 44%. Anteroposterior dissection HoLEP was newly developed to protect the urethral sphincter and therefore lower the incidence rate of SUI. This study was conducted to determine the SUI incidence rate after anteroposterior dissection HoLEP.
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              Leiomyoma of the prostate: CT and MR findings.

              Pure prostatic leiomyoma is very rare. We report a case of magnetic resonance imaging findings of prostatic leiomyoma. The mass was expansile and had a slightly higher signal intensity than skeletal muscle on T2-weighted images. Normal prostatic glandular tissue could be clearly distinguished from the tumor.
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                Author and article information

                Journal
                Cureus
                Cureus
                2168-8184
                Cureus
                Cureus (Palo Alto (CA) )
                2168-8184
                14 September 2023
                September 2023
                : 15
                : 9
                : e45273
                Affiliations
                [1 ] Department of Urology, St. Luke's International Hospital, Tokyo, JPN
                Author notes
                Article
                10.7759/cureus.45273
                10576844
                37846242
                1110df62-0fb8-41eb-92a6-e4b16d5cf27e
                Copyright © 2023, Sano et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 14 September 2023
                Categories
                Urology

                enlarged prostate,surgical morcellation,urethral leiomyoma,holmium: yag laser,dysuria

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