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A retrospective review of radiology registry identified 3 cases of diagnosed giant multilocular cystadenoma of  prostate. The first case illustrates a 59-year-old man with worsening voiding and storage symptoms of 2 months  duration. The prostate was enlarged with the right lobe being bigger than the left node and his PSA was 9.3 ug/l. MRI  showed large Multi cystic mass from the prostate and TRUS biopsy revealed adenocarcinoma prostate. Neoadjuvant  LHRH agonist shrunk the mass before radiotherapy. He has no urinary symptoms and PSA consistently less than  0.1. Repeat MRI showed highly shrunken mass. In the second case, we present a 79-year-old patient presenting  with rising PSA despite being on finasteride. MRI diagnosed large cystic and solid mass arising from the prostate and  extending to the abdomen. Tran’s rectal ultrasound guided biopsy plus aspiration of the fluid from the multiloculated  cyst revealed benign cystic adenoma with no evidence of any malignancy. Repeat MRI after 6 months of LHRH  agonist showed multiloculated cyst adenoma of the prostate appears stable with no significant reduction in size and  his PSA remains high. The third case is an 83-year-old presenting with LUTS, haematuria and rising PSA. He has a  past medical history of low grade prostate cancer (diagnosed at TURP). MRI scan showed an enlarged echogenic  prostate. TRUS biopsy of the mass identified complex proliferation of atypical glandular epithelium in a rather villous adenomatous pattern. Neoadjuvant LHRH agonist showed reduction in lower urinary symptoms.

journal of clinical case reports

Does Giant Multilocular Cystadenoma of Prostate Respond to LHRH Agonist or It Is a Case of Cystic Prostate Cancer Wrongly Diagnosed– A Report of 3 Cases and Review of Literature