Medical Treatment of the Prostate Gland. Part 11
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The Department of Urology of the New York Hospital
(Given January 31, 1941)
Sarcoma of the Prostate
Sarcoma of the prostate is relatively rare, and may occur at any age. A review of the literature by Lowsley and Kimball, in 1934, disclosed only 132 reported cases, 35 of which occurred in patients under 22 years of age. These tumors usually grow rapidly and attain large size, early infiltrating the bladder, seminal vesicles, and rectum. Growth of the tumor backward beneath the base of the bladder pushes the latter upward and forward, causing obstruction of the ureteral orifices, urethral orifice, and urethra, with resultant partial or complete retention. Growth of the tumor toward the perineum causes prolapse of the rectum, with obstruction to defecation and urination.
Diagnosis. Early diagnosis is essential. In early cases rectal examination may be negative, but usually reveals a palpable nodule. Occasionally the growth may be indurated and nodular, but usually it is of uniform consistency and has an elastic “balloon-like” feel; hence the condition may be erroneously diagnosed as abscess. The diagnosis can positively be made by needle biopsy.
Prognosis and Treatment. The prognosis is poor. The most favorable results have been achieved through the use of radium and Roentgen rays. In early cases, the skilled use of these agents may prove curative, and in late cases they may give relief and prolong life. Operative intervention should be limited to the relief of obstruction and the treatment of complications.
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