Large Phyllodes Tumour of the Seminal Vesicle: Case Report and Literature Review

Abstract

A rare case of phyllodes tumour arising in the seminal vesicle is reported here. A 59-year-old male presented with lower abdominal discomfort and symptoms of bladder outlet obstruction for 1 year. Transrectal ultrasonography and pelvic computed tomography and magnetic resonance imaging demonstrated a large mass posterior to the bladder and anterior to the rectum. Tumour excision and right seminal vesiculectomy were performed via a transvesical approach. The left seminal vesicle, bladder and prostate were not involved. The patient had an uneventful post-operative course and recovered well. There was no evidence of recurrence or metastasis during 22 months of regular follow up. The diagnosis, histological classification, treatment and prognosis of this case are presented together with a review of the literature. It is suggested that the behaviour of phyllodes tumour of the seminal vesicle is related to its histological parameters.

Why are epididymal tumours so rare?

“…As an anti-oxidative and immune-suppressive environment is also what maintains high numbers of spermatozoa quiescent and immunologically silent, the low incidence of cancer in the epididymis may be a direct consequence of its role in sperm maturation and storage. Such hypotheses are open to experimentation, but they may not explain the similarly low incidence of tumours in the seminal vesicles 160 (Table 1), which also deserves study. Further investigation into the regulation of the epididymal anti-tumourigenic activity may well offer insights that can be used in the prevention or treatment of cancers in general.…”

Phyllodes tumor of the verumontanum: a case report

“…This may be the first case of phyllodes tumor of the verumontanum. Previously reported phyllodes tumors are mostly located in the female breast tissue, followed by the prostate [2]. Less than 15 and 100 cases of phyllodes tumors of the seminal vesicle and prostate, respectively, have been reported to date.…”

“…The majority of phyllodes tumors of the breast have infiltrative margins. Phyllodes tumors are epithelial stromal tumors, with the unique feature of being a blend of stromal and epithelial tissues; the presence of both epithelial and stromal elements is necessary to confirm the diagnosis [2]. The misdiagnosis rate of breast phyllodes tumors is relatively high, since they are histologically similar to fibroadenoma.…”

“…It is important to differentiate phyllodes tumors from other benign breast tumors [1]. The accepted histological classification of phyllodes tumors in the breast is to divide masses into benign, borderline, and malignant subtypes according to features such as tumor margins (pushing or infiltrative), stromal overgrowth, tumor necrosis, cellular atypia, and the number of mitotic cells per high power field [2, 4, 6]. No cases of phyllodes tumor of the verumontanum have been reported, and it is difficult to develop any definitive criteria for its grading.…”

Cistoadenoma de vesícula seminal

“…Ella puede darse tomando la relación estroma/tejido epitelial, celularidad, necrosis o invasión de estructuras adyacentes, entre otros. 5,6 Por tal razón, los estudios por imágenes resultan cruciales para la adecuada valoración de su tamaño, comportamiento y grado de compromiso de estructuras adyacentes, lo que permite contar con la mayor información para definir la conducta terapéutica y el pronóstico.…”