Primäres Adenokarzinom der Samenblasen

Abstract

Primary malignancies of the seminal vesicles are extremely rare. They must be strictly differentiated from surrounding malignancies that may infiltrate the seminal vesicles from outside (e.g. prostate, rectum, and bladder carcinoma). MEDLINE and CANCERLIT review showed about 50 documented cases of primary seminal vesicle carcinoma so far worldwide in men between 19 and 90 years of age. Early diagnosis may be difficult due to lack of specific symptoms. Especially with a history of voiding dysfunction, haemospermia and/or haematuria, investigators should consider it. Primary diagnostic steps include digital rectal examination, transrectal ultrasound, and transrectal biopsy of the tumour. Additionally, CT and MRT scans show tumour masses corresponding to the seminal vesicles. Adenocarcinoma of seminal vesicles shows no expression of prostate-specific antigen or prostate-specific acid phosphatase, but there may be expression of carcinoembryonic antigen and cancer antigen 125. Radical surgery including radical prostatectomy and/or cystoprostatectomy including pelvic lymph node dissection offers a curative treatment pathway. Adjuvant or inductive medical treatment is of unproven worth, but a combination of hormonal deprivation and radiotherapy seems to be more effective than any chemotherapy.

Management of Seminal Vesicular Tumors in Port Harcourt, Southern Nigeria

“…Primary adenocarcinomas have been reported just more than 50 times and primary leiomyosarcomas about 8 times 1,2 . Secondary tumours of the seminal vesicle on the other hand are commoner and arise from primaries in a contiguous organ such as prostate, bladder or rectum 3 . Part of diagnostic work up therefore should include exclusion of tumours in any of these surrounding structures.…”

“…As in the cases reported, most cases present with nonspecific symptoms like haematuria, haematospermia, pelvic pain or storage lower urinary tract symptoms like frequency and urgency. 2,3 The pressure of the enlarging seminal vesicle reduces the functional capacity of the bladder and limits the ability of the bladder to expand, hence the storage symptoms. It is therefore important to at least consider differential diagnosis of seminal vesicle tumour in patients that present with lower urinary tract symptoms.…”

“…10 The second case was manged by a pulmonologist, haematologist and general surgeons. Early cases of seminal vesicle tumour are best treated with radical prostatectomy or cystoprostatectomy and pelvic lymph node dissection and these offer a curative treatment pathway 3,4 . In both cases presented above open surgery was also carried out.…”

“…However, cases of minimally invasive surgery for tumours on the seminal vesicle have been carried done. 12,13,14,15 Adjuvant radiotherapy or androgen deprivation has resulted in long term palliation in patients with advanced diseases 3,4 . Adjuvant chemotherapy has shown additional benefit in the management of advanced SVC.…”

Detecting diseases of neglected seminal vesicles using imaging modalities: A review of current literature

“…Immunophenotype of ASVs are positive for cancer antigen 125 and 7 ( 55 ). Primary diagnostic steps include, DRE identifies as a mass, which requires further examination, and TRUS and biopsy ( 89 , 90 ). MRI, CT with contrast, after histopathology, determine the mass as SVs adenocarcinoma .…”