Laparoscopic vesiculectomy for large seminal vesicle cystadenoma

Abstract

Cystadenomas of the seminal vesicles are extremely rare. Here, we report a large seminal vesicle cystadenoma. A 37‐year‐old man presented a 6‐month history of haemospermia, 10 days of Lower Urinary Tract symptoms (LUTSs) and gross haematuria. Transabdominal ultrasonography, computed tomography and magnetic resonance imaging were performed and revealed a large solid‐cystic pelvic mass morphometrically measured 7.0 cm × 11.9 cm × 8.6 cm on the right seminal vesicle, which caused hydronephrosis of the right kidney. The prostate‐specific antigen of the patient was 27.860 ng/dl. Laparoscopic exploration found the capsule of tumour was complete and the tumour came from the right seminal vesicle, in addition, the mass had a certain space with the bladder and prostate, which could be separated. So a nerve‐sparing Laparoscopic Vesiculectomy was performed at last, even though the intraoperative frozen section analysis could not make sure the nature of the tumour either. The postoperative pathology revealed cystadenoma of the seminal vesicle.

Cystadenoma of the seminal vesicle – Potential diagnostic pitfall: A case report and literature review

“…In agreement with the current WHO Classification of Tumours of the Urinary System and Male Genital Organs, 12 the cysts must be negative for PSA and positive for cytokeratin; stromal cells are weakly positive for smooth muscle actin and negative for S100 protein. Therefore, all the cases reported in the literature as cystadenomas, with no performed immunohistochemical panel, 1,13,15,16,18–20,23,25,26 are not cystadenomas beyond any doubt. Furthermore, some cases are probably not cystadenomas of the seminal vesicle, 3 but more likely MEST of higher degree.…”

“…Some critical issues have emerged from a careful literature review (Table 2): morphological criteria necessary for the diagnosis were often reported incompletely. 15,16,23,26 Moreover, according to the rarity of primary tumours of the seminal vesicles, it is necessary to exclude prostate cancer spreading into the seminal vesicle. In keeping with this paradigm, the immunohistochemical study of the lesion is mandatory.…”