Abstract：
A 48-year-old man with a medical history of hypertension and no family history of prostate cancer presented with abdominal distension, lower abdominal pain, and lower urinary symptoms. Physical examination revealed a palpable mass in the lower abdomen, and a digital rectal examination detected a firm mass on the anterior side of the rectum. Laboratory tests showed an elevated PSA level (7.9 ng/mL). Imaging studies indicated a solid mass connected to the prostate\'s posterior and rectum\'s anterior walls, along with bladder compression. Transperitoneal biopsy and histological analysis led to a diagnosis of a stromal tumor with uncertain potential malignancy. Considering the absence of apparent malignancy signs and the smooth outer wall of the tumor, the patient underwent, for the first time in the literature, a robot-assisted radical extraperitoneal prostatectomy for complete macroscopic resection. The surgery involved excision of the bulky pelvic mass, preservation of the urethra, and anatomical reconstruction. The postoperative course was uneventful, and we discharged the patient with no complications. The pathological examination documented the diagnosis of multilocular prostatic cystadenoma. Post-surgery follow-up examinations, including PSA levels and imaging scans, showed no signs of tumor recurrence. At the 3-, 6-, and 9-month follow-ups, the patient was asymptomatic and had fully recovered, with no urinary or sexual dysfunction reported.
摘要：
一名48岁的男性，有高血压病史，无前列腺癌家族史，出现腹胀，下腹部疼痛,和下尿路症状.体格检查发现下腹部有明显肿块，直肠指检发现直肠前侧有一块坚硬的肿块。实验室测试显示PSA水平升高（7.9ng/mL）。影像学检查显示，一个与前列腺后壁和直肠前壁相连的实体肿块，随着膀胱压缩。经腹膜活检和组织学分析可诊断出具有不确定潜在恶性的间质瘤。考虑到没有明显的恶性体征和肿瘤的光滑外壁，病人经历了,在文献中第一次，机器人辅助的根治性腹膜外前列腺切除术用于完全宏观切除。手术包括切除巨大的骨盆肿块，尿道的保存，解剖重建。术后进展顺利，我们没有并发症就出院了.病理检查证实了多房性前列腺囊腺瘤的诊断。术后随访检查,包括PSA水平和成像扫描，没有肿瘤复发的迹象。在3-，6-，和9个月的随访，病人无症状，已完全康复，无泌尿或性功能障碍报告。
