Pelvic mass: Schwannoma of the left seminal vesicle

Schwannomas rarely occur in seminal vesicles. Here, we report a schwannoma of the left seminal vesicle. A 55‐year‐old man presented no clinical symptoms, and a mass in the left region of the seminal vesicle was found incidentally in a medical examination. A computed tomography and magnetic resonance imaging of pelvic were obtained and revealed a 5.17 × 2.59 × 3.5 cm mass on the left seminal vesicle. Transrectal ultrasound‐guided seminal biopsy revealed a diagnosis of seminal vesical schwannoma. Laparoscopic resection of the tumour was performed. Postoperative pathology and immunohistochemical analysis revealed schwannoma arising from seminal vesical.     

Leiomyoma arising from the right seminal duct/seminal vesicle—Report of a rare case and review of the literature

We present a case of a patient with a large, symptomatic abdominal tumour, which finally could be classified as a leiomyoma arising from the right seminal duct/seminal vesicle. In computed tomography (CT) scan, it appeared as a 7.5 × 6.5 cm solid, supravesical mass. A cystoscopy as well as bilateral retrograde studies was normal, a transrectal ultrasound‐guided biopsy and an ultrasound‐guided transabdominal biopsy of the mass were inconclusive. Subsequently, we performed a tumour extirpation through a lower midline laparotomy. Histological examination showed a leiomyoma arising from the right seminal duct or seminal vesicle. In this article, we discuss clinical presentation, findings on imaging and management of this rare benign tumour and review the relevant literature where only 13 similar cases could be identified.     

Seminal Vesicle Cystadenoma: A Rare Clinical Perspective

A 52-yr-old man presented with severe obstructive urinary symptoms. Ten years earlier, a digital rectal examination disclosed a small mass above the prostate, and a computed tomography (CT) scan showed a 3.5-cm cystic tumor of the right seminal vesicle. He had been followed conservatively elsewhere. Reevaluation of the mass with a CT scan and magnetic resonance imaging showed that the mass had grown to a maximal diameter of 14 cm. A transabdominal needle biopsy revealed benign fibromuscular tissue. The tumor was then resected by an open transvesical approach. Pathology was consistent with a benign seminal vesicle cystadenoma. The natural history, pathology, and surgical approach are described.     

Infertility case presentation in Zinner syndrome: Can a long‐lasting seminal tract obstruction cause secretory testicular injury?

Zinner syndrome (ZS) could represent an uncommon cause of male infertility, as result of the ejaculatory duct block, which typically leads to low seminal volume and azoospermia. A 27‐year‐old Caucasian man reported persistent events of scrotal‐perineal pain and dysuria during the past 6 months. The andrological examination showed testicular volume of 10 ml bilaterally. Follicle‐stimulating hormone was 32.0 IU/L, luteinising hormone was 16.3 IU/L, total testosterone was 9.0 nmol/L, and 17‐beta‐oestradiol was 0.12 nmol/L. The semen analysis revealed absolute azoospermia, semen volume of 0.6 ml and semen pH of 7.6. The abdominal contrast‐enhanced computed tomography showed (a) left kidney agenesis; (b) an ovaliform hypodense mass of 65 × 46 millimetres with fluid content, which was shaping the bladder and the left paramedian prostatic region, compatible with a left seminal vesicle pseudocyst; and (c) an enlargement of the right seminal vesicle. The patient was diagnosed with ZS, and he was scheduled for robot‐assisted laparoscopic left vesiculectomy. Subsequently, testis biopsy was characterised by complete germ cell aplasia. The onset symptomatology is often blurred and difficult to detect. It is important to diagnose and manage early this condition, because a long‐lasting seminal tract obstruction could determine an irreversible secretory testicular injury.     

Schwannoma of a seminal vesicle

We present the first reported case of a schwannoma of the seminal vesicle that occurred in a 48-year-old man who presented with right lower quadrant abdominal pain. Computed tomography scan and magnetic resonance imaging revealed a mass in the patient's right seminal vesicle. The patient was also found to have a rising prostate-specific antigen level and underwent a transrectal ultrasound-guided biopsy of the prostate and seminal vesicles, which revealed prostate cancer and schwannoma of the seminal vesicle, respectively. Radical prostatectomy with en bloc removal of the seminal vesicle mass was performed and the patient has been free of disease 24 months postoperatively.     

A case of CA19-9-producing seminal vesicle cyst with ipsilateral renal agenesis

A case of CA19-9-producing seminal vesicle cyst with ipsilateral renal agenesis is reported. A 29-year-old man was admitted to our hospital for perineal pain and urinary retention. Digital rectal examination revealed a large soft mass that fluctuated in the area of the prostate and seminal vesicles. Magnetic resonance imaging revealed a right kidney defect, and ipsilateral dilation and cystic enlargement of the right seminal vesicle. Transrectal puncture of the seminal vesicle cyst was performed. The contents were pus and old red blood cells. Initially, the serum CA19-9 level was extremely high (145.8 U/ml) but was normalized by the treatment with antibiotics after the puncture. The symptoms subsided without recurrence.     

Cystadenoma of the seminal vesicle

Primary tumors of the seminal vesicle are extremely rare. Among them, there is a spectrum of tumors derived from both epithelium and stroma and so classified as epithelial-stromal tumors. Herein, we report a case of a cystadenoma in a 49-year-old asymptomatic man, detected in a routine ultrasonography for liver disease follow-up. The digital rectal examination detected a large mass anterior to rectum and posterior to bladder. Computed tomography scan and magnetic resonance imaging showed a normal prostate and a 9.0 cm cystic tumor, replacing the left seminal vesicle. The gross appearance and microscopic aspect was compatible with cystadenoma of seminal vesicle. Patient's postoperative recovery was uneventful. He is currently alive, 3 years after the diagnosis, with no signs of recurrence.     

腹腔镜精囊囊肿切除术

目的:探讨腹腔镜下精囊囊肿切除术的方法及临床疗效。方法:我院近期采用腹腔镜技术对2例伴有临床症状的精囊囊肿患者实施精囊囊肿切除术。术前经超声及CT等检查明确诊断,精囊囊肿大小为3.3cm×3.7cm×2.5cm,4.1cm×4.3cm×5.3cm。结果:2例手术均顺利完成,手术时间为140、100min,术中出血约50、20ml,术后6d出院。分别随访6、7个月,患者术前症状消失,无并发症发生,复查超声,均未见囊肿复发。结论:腹腔镜下精囊囊肿切除术具有视野清晰、操作精细、创伤小、恢复快等优点,是一种安全、有效的微创手术方式。     

精囊囊腺瘤1例报告并文献复习

目的:探讨精囊囊腺瘤的临床表现、病理特点和诊治方法。方法:对1例精囊囊腺瘤进行临床分析并结合文献复习,从临床表现、病理特点、诊治方法及疗效方面总结。结果:患者行连同肿瘤的精囊切除,病理报告符合精囊囊腺瘤,术后3个月超声、CT检查,未见肿瘤复发。结论:精囊囊腺瘤临床少见,易漏诊。常规直肠指检很必要,超声、CT有利于明确诊断。一般连同肿瘤的精囊切除即可,预后良好。     

Multilocular cystic adenomyoma of the pelvic cavity: A rare clinical and histological entity in a young man

We report a large complex cystic pelvic mass encountered in a 16-year-old man complaining of perineal discomfort. A large and elastic hard mass was palpated on the right anterior wall of the rectum with no discernible prostate on digital rectal examination. Prostatic tumor markers were elevated. Excretory urography and urethrocystography showed a filling defect with a smooth edge on the right side of the bladder. Magnetic resonance imaging demonstrated a mass with a mosaic pattern between the right side of the bladder and the rectum. We performed ultrasound-guided transrectal needle core biopsy of the mass. The pathologist suspected hyperplastic glandular epithelium of prostatic origin with focal inflammatory cell infiltration, but there was no sign of malignancy. We thought that the tumor arose from the prostate. Surgery was successfully performed. The tumor was located on the right side of the pelvic cavity and adhered to the right lobe of the seminal vesicle. En bloc excision was performed. This lesion histologically proved to be a multilocular prostatic tissue with a seminal vesicle component, without communication to the surrounding tissue. Such a lesion has not previously been reported in the literature.     

Effect of androgen deprivation on the expression of aquaporins in rat prostate and seminal vesicles

The aim of this study was to investigate the level of secretions of prostate and seminal vesicles and its association with the expression of AQP0, 1, 4, 5, 6 and 8 in castrated rats. Eight‐week‐old male Sprague‐Dawley (SD) rats (n = 18) were randomly divided into control group, castrated rats group and castrated followed testosterone replacement group. Four weeks after surgery, the secretions and expression of AQP0, 1, 4, 5, 6 and 8 of prostate and seminal vesicles were determined. Serum testosterone was significantly lower in castrated groups than in control and testosterone replacement groups (P < 0.05). The level of prostate and seminal vesicle secretions and the expressions of AQP0, 1, 4, 5, 6 and 8 in prostate and seminal vesicles were significantly lower in castrated group than in control and castrated followed testosterone replacement groups (P < 0.05). The decreased prostatic and seminal vesicle secretions in castrated rats may be related to the decrease in AQP0, 1, 4, 5, 6 and 8 in prostatic tissue and seminal vesicles.     

Primary squamous cell carcinoma of seminal vesicle: an extremely rare case report with literature review

Primary squamous cell carcinoma of seminal vesicle is extremely rare, and most cases regarding seminal vesicle tumors failed to address this kind of tumor. A 54-year-old male patient presented with intermittent painless visual hematuria for 6 months was hospitalized. Ultrasonography, computerized tomography and magnetic resonance imaging demonstrated a 4.4 cm × 3.6 cm × 3.0 cm mixed tumorous lesion in the left seminal vesicle. A transrectal needle biopsy revealed severe chronic inflammation. The mass was completely resected in a laparoscopic approach and was verified as a moderately differentiated squamous cell carcinoma in the seminal vesicle by post-surgical histopathological examination. The patient received totally 5 cycles of chemotherapy. A rectal metastasis was detected 7 months after the surgery.     

腹腔镜治疗精囊良性肿瘤3例报告

目的:探讨腹腔镜手术治疗精囊良性肿瘤的效果。方法:2007年4月至2008年6月我院为3例患者行腹腔镜精囊良性肿瘤切除术。术前均经B超、CT及MRI等检查明确诊断,肿物大小40mm×30mm×25mm~63mm×45mm×40mm。结果:3例手术均成功切除精囊占位。手术时间64~120min,平均84min,术中失血60~120ml,平均74ml。术后平均随访11.3个月,未见局部复发及远处转移。结论:腹腔镜手术具有创伤小、并发症少、住院时间短等优点,是治疗精囊良性肿瘤的有效方法。     

A case of prostatic cancer with a low PSA level accompanied with cystic formation requiring differentiation from adenocarcinoma of the seminal vesicle

A 70-year-old man with the complaint of macrohematuria and hematospermia was admitted to our hospital for further examination of a cystic formation of the right seminal vesicle, 3.6 cm in diameter, detected by magnetic resonance imaging(MRI). Cystoscopy revealed no remarkable change, but urine cytology was class III. The serum concentration of prostate specific antigen (PSA) was within the normal range of 1.83 ng/ml. Transperineal needle biopsy of the prostate and cystic tumor of the seminal vesicle revealed adenocarcinoma of the prostate and seminal vesicle, but immunostaining for PSA was negative, so we diagnosed the case as primary adenocarcinoma of the seminal vesicle. Bloody fluid of the cyst was obtained by transperineal aspiration, but no cancer cells were detected by cytological examination. Total prostatectomy was performed, and pathological findings was infiltration of prostate cancer into the seminal vesicle (pT3b) because immunostaining of the PSA was positive.     

Prostatic stromal sarcoma in a young adult: a case report

Prostate stromal sarcoma is quite rare, comprising only 0.1-0.2% of all prostate cancers. Here, we report one case of prostate stromal sarcoma in a 38-year-old man. Initially, the patient suffered from lower urinary tract symptoms, and intravenous pyelography showed a larger filling defect in the bladder. Transrectal ultrasound showed a huge heterogenous mass between the bladder and rectum. Abdominal computed tomography revealed prostate tumor with local invasion. Radical cystoprostatectomy with ileal conduit was performed; pathology revealed high-grade prostate stromal sarcoma with invasion to the right seminal vesicle and urethra. This article describes the pathology and immunohistrochemical features of this case and briefly reviews the literature.     

Alterations of morphology and phosphorylated protein expression in the seminal vesicles of diabetic mice

Although many studies reported the detrimental effects of type 1 and 2 diabetes mellitus (T1DM and T2DM) on testis, reproductive parameter changes in DM seminal vesicles have never been documented. This study aimed to examine the morphology, biochemical levels and tyrosine phosphorylation in seminal vesicles of T1DM and T2DM mice. Fifty‐six male C57BL/6 mice were divided into four groups (n = 14/each): T1DM control, T1DM, T2DM control and T2DM. T1DM mice were daily injected of streptozotocin (STZ; 40 mg/kg BW) for 5 days. T2DM mice received high‐fat diet for 14 days prior to STZ injection at a single dose (85 mg/kg BW). At the end of experiments (days 36 and 72), magnesium (MG) and fructosamine (FRA) levels, and phosphorylated protein expression in seminal vesicle were examined. The results showed that seminal and prostate weights and MG and FRA levels of T1DM animals were significantly increased as compared to T2DM mice. Some seminal histopathologies and decreased epithelial height were observed in both DM groups. Significantly, a 72‐kDa phosphorylated protein expression was increased in DM seminal vesicle. We concluded that changes of biochemical components and phosphorylated proteins in seminal vesicle of T1DM and T2DM mice may be associated with low‐quality seminal plasma.     

Round cells do not contaminate or mask human sperm proteome in proteomic studies using cryopreserved samples

Semen contains leucocytes and round cells, besides spermatozoa. The objective of this study was to identify whether the proteins from round cells and leucocytes affect the proteomic analysis of spermatozoa. Cryopreserved human sperm samples were divided into four groups: (1) samples with ≥1 × 10⁶/ml leucocytes unprocessed; (2) samples with ≥1 × 10⁶/ml leucocytes processed by 65% density centrifugation; (3) samples with round cells <1 × 10⁶/ml unprocessed; and (4) samples with round cells <1 × 10⁶/ml processed by 65% density centrifugation. Samples from each group (1, 2, 3 and 4) were pooled (n = 5) for quantitative proteomic analysis using liquid chromatography‐tandem mass spectrometry (LC‐MS/MS). Comparative analysis revealed nine differentially expressed proteins (DEPs) groups 1 and 2. Moreover, five DEPs were identified between groups 3 and 4. We observed that cylicin‐1, Atlastin‐1 and vesicle transport protein SFT2B are specific to spermatozoa, and none of them were associated with leucocytes. The number of DEPs in spermatozoa of processed and unprocessed cryopreserved semen samples was negligible. Our results indicate that the presence of round cells (<1 × 10⁶/ml) in the seminal ejaculation does not interfere in the accurate detection of spermatozoa proteome by LC‐MS/MS.     

Metastasizing Seminal Vesicle Adenocarcinoma in a Wistar Rat

An adenocarcinoma in the seminal vesicles of a 15‐month‐old male Wistar rat from a 30‐month inhalation study is described. The rat was killed because of cachexia, apathy and a large palpable mass in the abdominal cavity. Macroscopic examination of the abdominal cavity revealed a 3.8 cm × 3.2 cm yellow‐grey to pink mass, firm to soft in consistency. The cut section revealed cystic spaces. Histologically, the mass consisted of epithelial cells arranged in glandular and solid patterns with abundant amounts of connective tissue. Epithelial tumour cells were round‐to‐cylindrical with round‐to‐oval basophilic nuclei and one or two prominent nucleoli and a distinct eosinophilic cytoplasm. The glandular structure contained clusters of macrophages in their lumen with eosinophilic cytoplasm and indented nuclei. Extensive necrosis and reactive inflammation were present. The histological features of the small nodules in the pancreas and on the surface of the liver, rectum and urinary bladder resembled those of the primary tumour in the seminal vesicles. Based on these criteria, the neoplasm (mass) was diagnosed as an adenocarcinoma of the seminal vesicles. The immunohistological examination confirmed the diagnosis, i.e. immunostaining was positive for cytokeratins (4, 7, 14, 15, 18, and 19), vimentin, PCNA, and ED₁.     

A seminal vesicle cyst treated by transurethral resection: a case report

A 40-year-old man with dysuria was referred to our department on November, 18, 2004. A transabdominal ultrasonography revealed a cystic mass arising from his bladder neck. Computed tomography and magnetic resonance imaging revealed the cyst to be homogeneous and ovally shaped with a clear margin. Bilateral vasography showed the compression of the left seminal vesicle by the cyst and there was communication between the cyst and the left seminal vesicle for diagnosis of the seminal vesicle cyst, percutaneous needle aspiration was performed. The aspirated fluid included microscopical spermatozoa and proved negative for cytology. Absolute ethanol was injected into the cyst and transurethral unroofing of the cyst was performed on January 14, 2005. The prostate was resected until we reached into the cyst.