Phyllodes tumor of the seminal vesicle: Case report and literature review

Abstract

A 39-year-old man presented with urinary retention and lower abdominal discomfort at our hospital, and a computed tomography scan showed a huge cystic mass posterior to the urinary bladder. During surgical exploration, a mass superior to the prostate in the region of the left seminal vesicle was found. Histologically, the tumor was characterized by cystically dilated or slit-like glands mixed in a densely cellular stroma with pleomorphism and resembled those of phyllodes tumor of the breast or prostate. The glandular epithelium within the tumor showed focal lipofuscin pigment and negative staining for prostate specific antigen (PSA). The stromal cells showed positive immunoreactivity for vimentin and CD34, and focal positive reactions for desmin and alpha-smooth muscle actin. Mitosis was present 0 to 1 per 10 high power fields of magnification in the stromal cells. Approximately 20% of the stromal cells were positive for progesterone receptor. The patient is alive with no evidence of disease 12 months after surgery. Mixed epithelial-stromal tumors of the seminal vesicle are extremely rare. A combination of stromal cellularity, atypia and mitosis might be used for the histological grading, and a prostatic origin might be excluded by the location of the primary lesion itself and by the failure to show PSA.

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

“…The focal necrosis was < 5% of the total mass and other histological features were compatible with low-grade phyllodes tumour: the tumour had an intact external surface with no infiltrating margins and macroscopically the mass had a cystic nature, whereas high-grade phyllodes tumours are usually solid. 8 In addition, the outcome was consistent with a histological classification between low and high grade.…”

Phyllodes Tumor of Vulva: A Brief Diagnostic Review

“…18 He also highlighted the histologic and ultrastructural differences based on simpler gland configuration, different acinar epithelium, and the fewer electron-lucent secretory granules seen in mammary glands. 1 Additional support for the theory for mammary-like anogenital glands being the origin of mammary-type neoplasms and conditions, including phyllodes, comes from reports of those entities in regions that are not part of the caudal milk line, including phyllodes of the perianal region, 3,13 prostate, 18,19 and seminal vesicle. 19,20 Giger et al 20 demonstrated strong NY-BR-1 expression by the phyllodes tumor of the vulva with similar strong expression from nearby mammary-like anogenital glands, suggesting that the phyllodes tumor of the vulva likely originate from these glands.…”

“…1 Additional support for the theory for mammary-like anogenital glands being the origin of mammary-type neoplasms and conditions, including phyllodes, comes from reports of those entities in regions that are not part of the caudal milk line, including phyllodes of the perianal region, 3,13 prostate, 18,19 and seminal vesicle. 19,20 Giger et al 20 demonstrated strong NY-BR-1 expression by the phyllodes tumor of the vulva with similar strong expression from nearby mammary-like anogenital glands, suggesting that the phyllodes tumor of the vulva likely originate from these glands. The involvement of hormones in the development of phyllodes tumors of the vulva is suggested by reports that correlate the appearance of tumor with the onset of puberty 14 and rapid growth during 17-b-estradiole treatment for menopausal symptoms.…”

“…20,21 The presence of similar tumors in prostate and seminal vesicles with a different immunohistochemical pattern suggest alternate mechanisms for these locations. 18,19 CLINICAL FEATURES The Table summarizes the clinical and pathologic characteristics of the previous cases reported in the literature. The patients' age ranged from 17 to 69 years, with most of the tumors located in the labium majus.…”

First case of primary phyllodes tumor of the pancreas: case report and findings of immunohistochemical and ultrastructural studies

“…Extra-mammary phyllodes tumors have been reported in the prostate and seminal vesicles [1,2]. Mesenchymal tumors involving the pancreas are rare, but various histological types have been reported, including leiomyosarcoma, leiomyoma, inflammatory myofibroblastic tumor (IMT), perivascular epithelioid cell tumor, schwannoma, solitary fibrous tumor (SFT), and extra-gastrointestinal stromal tumor (extra-GIST) [3][4][5][6][7][8][9][10].…”