Li Huang, Congbo Chen, Hao Li, Shengtao Ling, Hongxia Chen
Primary myeloid sarcoma arising in the prostate is an exceptionally rare extramedullary manifestation of acute myeloid leukemia. Its nonspecific clinical presentation frequently leads to diagnostic delay or misdiagnosis. This report aims to enhance clinical awareness and diagnostic accuracy through a detailed analysis of a representative case and a systematic review of the existing literature. We report a 74-year-old male initially misdiagnosed as benign prostatic hyperplasia, confirmed post-PKRP by MPO-positive pathology. He received AML-directed systemic chemotherapy after transfer to hematology. Normal PSA and MPO positivity aid diagnosis; obstruction relief plus AML-regimen chemotherapy is core. Lysozyme testing was not performed.