Histopathological changes in the prostate after SpaceOAR hydrogel placement

Abstract

Spacing Organs at Risk (SpaceOAR) hydrogel has been part of the standard protocol in radiation treatment of prostate cancer to minimize radiation damage to the rectum. However, patients may not always follow through with the initial radiation therapy after the placement of the hydrogel due to involvement of the small bowel in the radiation field as seen in our patient. Here, we report the case of a 58-year-old male who underwent robot-assisted laparoscopic prostatectomy two months after SpaceOAR placement, where the prostate specimen was sent to pathology only with clinical history of “prostate cancer.” This case highlights three important points. First, to describe the histopathological changes in a prostatectomy specimen status post-hydrogel placement for radiation treatment of prostate cancer as it is not well-documented. Second, to distinguish the differential diagnoses of granulomatous prostatitis and mucinous adenocarcinoma. And most importantly, to provide complete details with the histopathology requisition form to efficiently correlate histopathologic changes in the appropriate clinical context.