A 58-year-old man was admitted to hospital with gross hematuria and a history of a prostate nodule that had been unchanged in size over a period of 3 years. A digital rectal examination revealed a nodule, confirmed by pelvic computed tomography and magnetic resonance imaging scans. Microscopic findings from a transrectal ultrasound-guided biopsy of the prostate revealed phyllodes tumor of the prostate and seminal vesicle, with well-differentiated fibrosarcoma and undifferentiated sarcoma. An initial prostate-specific antigen (PSA) value was 2 ng/mL (normal, less than 4 ng/dL). Over time, the mass grew in size and caused abdominal bloating, bladder outlet obstruction, and kidney failure. A radical prostatectomy was performed and the patient had an uneventful postoperative course. Thereafter, the patient received adjuvant radiation therapy. A few months after surgery, the symptoms worsened and imaging revealed a recurrence and metastasis to his lungs. The patient is currently receiving palliative chemotherapy.
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