Incidental Large Exophytic Prostatic Cyst in an Asymptomatic Male: Diagnostic Evaluation and Management
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ID: 314173
2026
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Abstract
Prostatic cysts are generally small, intraprostatic, and incidental. Large, multiloculated, exophytic cysts are rare and can mimic pelvic neoplasms. We report an incidental discovery of a large exophytic prostatic cyst in an asymptomatic 57-year-old male. Multiparametric magnetic resonance imaging (mpMRI) demonstrated T1 and T2 hyperintensity, suggesting proteinaceous or hemorrhagic content. Magnetic resonance spectroscopy (MRS) provided essential metabolic context, revealing a preserved citrate peak and a high citrate-to-choline ratio, which supported a benign impression. This was further corroborated by a low prostate-specific antigen (PSA) density (0.068 ng/mL/cc). Transrectal ultrasound–guided aspiration yielded 20 mL of hazy brownish fluid; cytopathology confirmed the absence of malignancy. This case emphasizes the diagnostic value of combining mpMRI, MRS, and PSA density to characterize large, complex prostatic “incidentalomas” non-invasively. Such a multi-modal approach facilitates conservativemanagement, sparing asymptomatic patients from unnecessary surgical intervention even in the event of subsequent cyst reaccumulation.
| Reference Key |
salati2026incidental
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|---|---|
| Authors | Aasim Ajaz Salati, Sajad Ahmad Salati |
| Journal | Yemen Journal of Medicine |
| Year | 2026 |
| DOI |
10.63475/yjm.v5i1.0377
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| URL | |
| Keywords | Keywords not found |
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