Figure 2 (Case 2).

The tumor blood supply originated from the multiple feeders. A 47-year-old man presented with progressive obstructive voiding symptoms and repeated episodes of gross hematuria for the past 2 months. For relief of his urinary retention, a transurethral catheter was inserted. Pathological examination of the prostate needle biopsy indicated leiomysarcoma confirmed with immunohistochemical staining. (A) Digital subtraction angiography (DSA) of the pelvic arteries shows a large hypervascular mass (asterisk) supplied from the branches of the internal iliac arteries (white straight arrow); (B) DSA of the inferior mesenteric artery (white straight arrow) shows the contrast tumor staining (asterisk); (C) DSA of the middle sacral artery (white straight arrow) shows the contrast staining in the lower part of the tumor (asterisk); (D) Axial contrast-enhanced T1-weighted magnetic resonance image (MRI) obtained before transcatheter arterial chemoembolization (TACE) shows a large hypervascular tumor arising from the prostate gland (asterisk) with infiltrating the bladder. Noted the indwelling catheter (white straight arrow); and (E) Axial contrast-enhanced T1-weighted MRI obtained at 18 months after four sessions of TACE shows almost complete necrosis of the prostatic tumor (asterisks). Subsequent radical prostatectomy was performed and pathological examination showed complete necrosis in the excisional specimen with negative margins. No further treatments were performed and he is alive asymptomatic with imaging disease free during his 42 months of follow-up.