Sarcomatoid Prostate Carcinoma: A Case Report

Abstract Background: Sarcomatoid carcinoma of the prostate is an extremely rare and aggressive variant of prostate cancer, posing significant diagnostic and therapeutic challenges due to its mixed histological features. It represents less than 0.1% of prostate cancer cases and is characterized by the presence of both glandular and sarcomatoid components. Case Presentation: We report the case of a 58-year-old male from rural Morocco who presented with a two-month history of urinary symptoms. Initial imaging revealed prostatic enlargement and a PSA level of 9ng/l, prompting further investigation with CT imaging, which identified a significant prostatic abscess. Surgical drainage unexpectedly revealed a hard mass, leading to transrectal biopsies and subsequent histopathological analysis confirming the diagnosis of sarcomatoid prostate carcinoma. The patient underwent radical prostatectomy post-diagnosis. Conclusions: Sarcomatoid carcinoma of the prostate remains a diagnostic challenge due to its rarity and mixed histological features. This case highlights the importance of considering sarcomatoid carcinoma in the differential diagnosis of prostate malignancies, especially in patients with atypical presentations such as prostatic abscesses. Early recognition and appropriate management are crucial for optimizing patient outcomes in such cases.