Stumped by rapid symptomatic prostatic regrowth: A case report on a STUMP tumour of the prostate resected with HoLEP

INTRODUCTION: Stromal Tumour of Undetermined malignant potential (STUMP) is a rare category of the prostate benign tumours, which has a variable clinical presentation, behavior and different approaches to manage it. CASE PRESENTATION: A 57 year-old male presented with voiding symptoms of the urinary tract and an increased PSA (14.7 ng/ml). Ultrasound and multiparametric MRI showed an enlarged prostate of 41 ml. Transurethral resection of the prostate (TURP) was performed with 11 g benign tissue removed. The patient presented one year later with the same symptoms; further ultrasound and parametric MRI demonstrated huge recurrence in the transition zone with a new prostate size of 131 ml. DISCUSSION: Despite no malignancy being identified in the initial TURP histology, the transition zone prostatic tumour behaved aggressively and recurred in just one year. For the first time in literature, the tumour recurred rapidly to three times the initial size and was removed using Holmium Laser enucleation of the prostate (HoLEP), after which no recurrence was seen in 11 months period. CONCLUSION: HoLEP can be used to successfully enucleate STUMP tumours but the clinical behavior of the STUMP in prostate is still not understood well because of its rareness.