Mischievous malakoplakia: A potential pitfall of mpMRI of the prostate?

Interpretation of multiparametric magnetic resonance imaging (mpMRI) for prostate cancer diagnosis and staging can be challenging and, in some cases, benign prostate disease can mimic locally advanced malignancy. We present the case of a 57 year-old male with biopsy-proven Gleason 3 + 4 prostate can...

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Bibliographic Details
Published in:Urology case reports 2020-09, Vol.32, p.101222, Article 101222
Main Authors: Rezaee, Michael E., Ren, Bing, Sverrisson, Einar F., Seigne, John D., Dagrosa, Lawrence M.
Format: Article
Language:English
Subjects:
Malakoplakia
Multiparametric magnetic resonance imaging
Oncology
Prostate Cancer
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Summary:Interpretation of multiparametric magnetic resonance imaging (mpMRI) for prostate cancer diagnosis and staging can be challenging and, in some cases, benign prostate disease can mimic locally advanced malignancy. We present the case of a 57 year-old male with biopsy-proven Gleason 3 + 4 prostate cancer and a preoperative mpMRI showing extraprostatic extension who was later found to have infiltrating malakoplakia on final surgical pathology. This case highlights the importance of recognizing that malakoplakia of the prostate can present as a PI-RADS 5 lesion with extracapsular extension on mpMRI. Such cases can result in wide-excision, non-nerve sparing radical prostatectomies that may be unwarranted.
ISSN:2214-4420
2214-4420
DOI:10.1016/j.eucr.2020.101222