Tuberculosis of the Prostate: A Case Report

Prostate tuberculosis is a rare form of genitourinary tuberculosis. It poses a major diagnostic challenge because its clinical and biological presentation often mimics tumor pathology (benign or malignant). We report the case of a 69-year-old man who presented with acute urinary retention. His PSA level was elevated and the digital rectal exam suggested suspicious prostatic hypertrophy. An adenomectomy was performed. Pathological examination revealed adenomyomatous hyperplasia of the prostate with no morphological signs of malignancy. The prostatic parenchyma also contains epithelioid and giant cell granulomas with caseous necrosis, leading to a diagnosis of caseous follicular tuberculosis associated with adenomyomatous hyperplasia. Prostatic localization of tuberculosis is rare even in areas where it is endemic. The misleading clinical presentation can mimic prostate adenocarcinoma. Recent cases reported in the literature confirm the difficulty of diagnosis. This case highlights the importance of considering prostatic tuberculosis in the differential diagnosis of prostatic hypertrophy, particularly in regions with a high prevalence of tuberculosis. Pathological examination has an essential role in establishing the diagnosis and determining the treatment.