Granulomatous prostatitis after bacille Calmette-Guérin instillation resembles prostate carcinoma:A case report and review of the literature  

作　　者：Yu Yao Jun-Jie Ji Hai-Yun Wang Li-Jiang Sun Gui-Ming Zhang 

机构地区：[1]Department of Urology,The Affiliated Hospital of Qingdao University,Qingdao 266003,Shandong Province,China

出　　处：《World Journal of Clinical Cases》2023年第9期2051-2059,共9页世界临床病例杂志

基　　金：Supported by the Natural Science Foundation of Shandong Province,No.ZR2021MH354.

摘　　要：BACKGROUND Bacille Calmette-Guérin(BCG)instillation is recommended in patients with nonmuscle-invasive bladder cancer who have intermediate-risk and high-risk tumors.However,granulomatous prostatitis is a rare complication induced by BCG instillation,which can easily be misdiagnosed as prostate cancer.Here,we report a case of granulomatous prostatitis that resembled prostate cancer.CASE SUMMARY A 64-year-old Chinese man with bladder cancer received BCG instillation.Three days later,he stopped BCG instillation and received anti-infective therapy due to the urinary tract infection.Three months after BCG restart,he had rising total prostate-specific antigen(PSA)(9.14 ng/mL)and decreasing free PSA/total PSA(0.09).T2-weighted images of magnetic resonance imaging(MRI)showed a 28 mm×20 mm diffuse low signal abnormality in the right peripheral zone,which was markedly hyperintense on high b-value diffusion-weighted MRI and hypointense on apparent diffusion coefficient map images.Considering Prostate Imaging Reporting and Data System score of 5 and possibility of prostate cancer,a prostate biopsy was conducted.Histopathology showed typical features of granulomatous prostatitis.The nucleic acid test for tuberculosis was positive.He was finally diagnosed with BCG-induced granulomatous prostatitis.Thereafter,he stopped BCG instillation and received anti-tuberculosis treatment.During 10 mo follow-up,he had no evidence of tumor recurrence or symptoms of tuberculosis.CONCLUSION Temporarily elevated PSA and high followed by low signal abnormality on diffusion-weighted MRI are important indicators of BCG-induced granulomatous prostatitis.

关 键 词：Granulomatous prostatitis Prostate cancer Bacille Calmette-Guérin Magnetic resonance imaging Prostate-specific antigen Case report 

分 类 号：R737.25[医药卫生—肿瘤]