PRIMARY EXTRAMEDULLARY LEUKEMIA OF THE PROSTATE - CASE-REPORT AND REVIEW OF THE LITERATURE

We present the case of a 67-year-old male with primary extramedullary leukemia of the prostate gland, the first reported case in the literat ure to the best of our knowledge. His initial symptoms consisted of ep isodes of urinary retention. He underwent transurethral resection of t he prostate, and a diagnosis of high-grade lymphoma was rendered. He t hen received a course of doxorubicin-based lymphoma chemotherapy regim en. However, based on a panel of immunocytochemical stains, a diagnosi s of extramedullary leukemia or chloroma was confirmed. His bone-marro w examination at this point was normal. He underwent radiation therapy to the prostate with a total dose of 3960 cGy. Seven months after his initial presentation, he progressed to acute nonlymphocytic leukemia (ANLL), M2 by FAB classification. He was successfully treated with ind uction and consolidation chemotherapy with Ara-C and idarubicin, and w as maintained in complete remission up to 19 months of follow-up. Eigh t other cases of prostatic leukemia reported in the literature are pre sented. Five cases occurred in association with ANLL, 2 cases as sites of ANLL relapse, and 1 case in association with myelodysplasia. The u se of immunohistochemical stains has aided us in diagnosis of extramed ullary leukemia. Surgery, radiation therapy, and chemotherapy play com plementary roles in the treatment of prostatic extramedullary leukemia . (C) 1996 Wiley-Liss, Inc.