Abstract
BACKGROUND: Solitary fibrous tumor (SFT) is a rare mesenchymal neoplasm that typically occurs in the pleura. Prostatic SFT is uncommon, and periprostatic origin is exceedingly rare. To our knowledge, this is the first documented case of a patient who underwent robot-assisted laparoscopic prostate-sparing resection of a periprostatic SFT. CASE PRESENTATION: A 66-year-old male with no urinary or systemic symptoms was incidentally diagnosed with a periprostatic mass during routine imaging. Core needle biopsy revealed a neoplastic spindle cell proliferation exhibiting nuclear expression of signal transducer and activator of transcription 6 and cluster differentiation 34, consistent with a periprostatic SFT. Intraoperative findings revealed a well-circumscribed tumor originating from the prostatic fascia, enveloping the dorsal venous complex and neurovascular bundle. A prostate-sparing tumor resection was performed, achieving complete excision while maintaining both sexual and urinary functions. Postoperative surveillance over 12 months revealed no evidence of recurrence or metastasis on imaging and clinical evaluation. CONCLUSION: Periprostatic SFT represents an extremely rare clinical entity requiring individualized management strategies to balance oncological control with functional preservation. This report provide a management paradigm for preserving genitourinary function. Enhance the imaging, diagnosis, treatment and prognosis of periprostatic SFT among clinical physicians.