Abstract
Clinical History:
This is a case report video of a 58-year-old man, with a past medical history of atrial fibrillation and basal cell carcinoma. He had obstructive lower urinary tract symptoms, and his prostate specific antigen (PSA) was evaluated at 35 ng/mL.
Physical Examination:
His digital rectal examination showed a T2b in the right lobe, and MRI concluded in a 28-cc prostate, with a 21 mm Prostate Imaging Reporting & Data System 5 right lobe peripheral and transitional zone and capsular involvement as well as right seminal vesicle base. A 62-mm cyst in the left seminal vesicle was also found.
Diagnosis:
Targeted biopsies revealed grade group (GG) 5 on all biopsies from right side, and one biopsy positive on left base GG 5.
Treatment:
Decision to undergo a radical prostatectomy (RP)+extended lymphadenectomy in a trimodal treatment option was decided in the local multidisciplinary team.
Outcomes:
Robotic time was 180 minutes and blood loss was 300 mL. Final report showed a T3b, 23 mL International Society of UroPathologists GG 5, involving both lobes of the prostate, with focal margin of 0.1 mm on right side. No position lymph nodes were found, and confirmation of Mullerian duct cyst on final pathology report. The postoperative PSA <0.05 (patient on hormonotherapy). He had a good urinary flow, with 2 to 3 pads/day at the 1-month postoperative follow-up consultation. This is the first case ever of robot-assisted RP with a large Mullerian duct cyst (MDC) ever reported in literature, and the fourth case of robotic approach 1 –3 to retroperitoneal MDC in adults.
Patient gave his informed consent for the recording and publication of the video.
Authors have received and archived patient consent for video recording/publication in advance of video recording of procedure.
There are no conflicts of interest, and the authors disclose no commercial associations during the past 3 years and the creation of this video.
Runtime of video: 4 mins 51 secs
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