A 67-year-old male patient, with no past history of interest, attended urology for the first time, referred by his primary care doctor, due to symptoms of prostatism. Physical examination revealed a prostate of adenomatous consistency and increased size (III/IV). Transrectal ultrasound showed heterogeneous parenchyma, with isolated calcifications in the right lobe, without hypoechoic images and with a prostate volume of 101.7 c.c. In the analyses, elevated PSA (13.08 ng/ml.). A transrectal prostate biopsy was indicated.

The result of the pathological anatomy was reported as prostatic blue nevus. It describes a prostatic parenchyma with chronic inflammation and granulomatous foreign body type reaction, with the presence of intracytoplasmic granules and dendritic spindle-shaped melanocytes. There is no evidence of malignancy in any of the samples.