Case Report: Xanthogranulomatous prostatitis, a difficult differential diagnosis of prostate adenocarcinoma

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A variety of benign conditions of the prostate can clinically mimic prostatic adenocarcinoma, thus raising a diagnostic problem. Xanthogranulomatous prostatitis, a rare form of non-specific granulomatous prostatitis, is considered among those pathologies that can clinically, biochemically and even radiologically behave as a prostate carcinoma. We report an additional case of a patient with initial clinical suspicion of prostatic carcinoma, but whose histopathological report revealed a xanthogranulomatous prostatitis. Objectives Course Objective Xanthogranulomatous prostatitis is a rare benign inflammatory process of the prostate. Clinical, biochemical and imaging similarities make xanthogranulomatous prostatitis a difficult differential diagnosis of prostatic adenocarcinoma.. We report the case of a 62 year-old diabetic patient, with 3 months of lower urinary tract symptoms. On digital rectal examination, the prostate was hard and nodular. Initial prostate-specific antigen (PSA) was 43.97 ng/mL, with urine analysis and transabdominal ultrasonography not showing any alterations. A multiparametric magnetic resonance imaging (mpMRI) of the prostate was performed and showed two foci that were classified as PI-RADS 4 lesions. A transrectal ultrasound guided prostate biopsy was then realized.