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 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Aasim Ajaz Salati, Sajad Ahmad Salati
Journal Yemen Journal of Medicine
Year 2026
DOI
10.63475/yjm.v5i1.0377
URL
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