Testicular Torsion in a Rare Case of Prostatic Spindle Cell Rhabdomyosarcoma

Spindle cell sarcoma of the prostate is a rare variant of rhabdomyosarcoma (RMS), with the clinical experience limited to a handful of cases in the literature. We report a rare case of spindle cell rhabdomyosarcoma (SC-RMS) who presented to us with testicular torsion features. A 20-year-old male presented initially with lower urinary tract symptoms and features of epidiymo-orchitis, which was managed conservatively. He later presented with features suggestive of testicular torsion and underwent orchidopexy. The patient developed postoperative urinary retention. On per-rectal examination, there was gross prostatomegaly. He was evaluated with a trans-rectal biopsy and contrast-enhanced computed tomography (CECT). Subsequently, he was found to have metastatic prostatic SC-RMS, which is a rare disease. He was started on chemotherapy and radiotherapy. SC-RMS is a variant that has a comparatively favorable prognosis in children and an aggressive course in adults, as reported in the few cases so far. The treatment regimen is still evolving, and there is no consensus on the therapeutic approach. All these factors together result in the dismal outlook of patients diagnosed with this condition.