Xanthogranulomatous prostatitis with prostato-rectal fistula: a case report and review of the literature

PURPOSE: Xanthogranulomatous prostatitis (XP) is a rare form of nonspecific granulomatous prostatitis that can clinically mimic high-grade prostatic carcinoma. It is difficult to diagnose it definitely in clinical settings. METHODS: We report a case of XP with prostate-rectal fistula and review the relevant literatures. RESULT: A 75-year-old man presented with rectal bleeding when he urinated. A locally advanced carcinoma of prostate was suspected initially following the physical, imaging, and hematologic examinations. Subsequently on histopathological and immunohistochemical staining after needle biopsy of the prostate, a diagnosis of XP was made definitely. The patient was catheterized temporarily and treated with tamsulosin and estrogen. The patient underwent uneventful recovery after this conservative therapy. CONCLUSION: Histologic and immunohistochemical analyses are valuable in differentially diagnosing XP from high-grade prostate carcinoma. Treatment strategy of XP in principle is recommended to be the conservative method. Long-term follow-up earns are highly regarded considering the possibility of coexisting prostate cancer.