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Primary seminal vesicle adenocarcinoma is a rare malignancy of the male genito-urinary system with only a few confirmed reported cases. Initial tissue diagnostic modality is often a core biopsy specimen. Here, we report this rare entity in a 50-year-old male, highlighting the histomorphological and immunohistochemical approach to the core biopsy specimen of the seminal vesicle mass. The patient presented with a history of haematospermia and gross haematuria for one year, and radiological workup was found to have a right seminal vesicle mass. A trans-rectal ultrasound guided core biopsy revealed a tumourous lesion with a predominant papillary architecture and cytological features of neoplasia. Based on positivity for CK7, PAX-8 and CA-125, and Ki-67 index of 30%-40% and negativity for PSA, AMACR, CK20, CDX-2, p63, GATA3, WT1 and calretinin, a diagnosis of primary seminal vesicle adenocarcinoma was offered. The diagnosis was also confirmed on the surgically resected specimen. This case depicts the approach of a pathologist to diagnose this rare entity on the core biopsy specimen and the possible differential diagnoses one must consider.

Primary diseases of the seminal vesicles (SV) are very rare entities.Nonneoplastic lesions of the seminal vesicles include amyloidosis, inflammation, calcification and calculi, radiation-induced changes, and basal cell proliferation.Seminal vesicles are frequently involved by tumors originating elsewhere, in particular by prostatic adenocarcinoma, urothelial carcinoma, and rectal adenocarcinoma. On the contrary, primary tumors of the seminal vesicles are rare. Among these, the most common is seminal vesicle adenocarcinoma. To date, less than 100 cases have been reported in literature. Morphologically, primary SV adenocarcinoma is described as a papillary or sheetlike growth architecture, with trabecular and glandular patterns, composed by hobnail tumor cells, frequently with mucinous differentiation. On the contrary, mesenchymal tumors include benign lesions such as leiomyoma, schwannoma, fibroma, paraganglioma, solitary fibrous tumor, cystadenoma, and mixed epithelial and stromal tumors (MEST).Cystadenoma is a rare benign tumor, while MESTs are biphasic tumors with stromal and benign epithelial components. Histological features such as stromal atypia, mitotic activity, nuclear pleomorphism, and tumor necrosis distinct MEST in low-, intermediate-, and high-grade tumors.In recent years, multiple studies reported a link between tumorigenesis and tumor microenvironment. In this regard, the molecular mechanisms connecting prostate cancer (PCa) progression and the host microenvironment have been described and include extracellular matrix (ECM), myofibroblasts, cancer-associated fibroblasts (CAFs), neuroendocrine cells, adipose tissue, and the immune-modulatory cells. Of note, only one study evaluated the influence of seminal vesicle's tumor microenvironment (SVME) on prostate cancer cells so far. Besides, in vivo experiments in NOD/SCID mice clarified the influence of SVME on PCa progression. As such, the injection of PC3 cells into the prostate or the SV resulted in different tumor aggressiveness, and the incidence of retroperitoneal lymph node metastases was significantly higher in mice models receiving SV injection. These findings demonstrated that SVs (rather than the prostate) offer a stimulating tumor microenvironment for growth and invasion of prostate cancer cells.

The rarity of primary seminal vesical adenocarcinoma (PSVA) coupled with mostly late and advanced presentation with high mortality makes it an unanticipated malignancy with poor prognosis. Although there has been sporadic reporting of cases, the dearth of literature makes standardised care a challenge. The detection has incorporated immunohistochemistry for establishing the site of origin as well as the differentiation of primary from metastatic cancer. Surgical management with seminal vesiculectomy continues to be the mainstay of treatment, but difficult anatomy and delayed intervention do lead to an increased chance of residual disease that may warrant further adjuvant chemoradiation. We present a case report where PSVA developed in a patient with Zinner syndrome—an observation that is extremely rare with a literature review of PSVA including the various aspects of management including contemporary diagnosis techniques.

Primary seminal vesicle adenocarcinoma is one of the rarest genitourinary cancers. The pathogenesis is unknown and clinical manifestations are protean. There is no defined treatment for this disease and various combinations of surgery, chemotherapy, radiation therapy and hormonal therapy have been used in the past. Here, we have reported a primary seminal vesicle adenocarcinoma with hepatic metastases, managed with multiagent chemotherapy (oxaliplatin and 5-fluorouracil based) and androgen ablation (with triptorelin). The key to management of such a case is early diagnosis and multimodal treatment. The reported survival rate continues to be poor even for a localised disease. A consolidated follow-up protocol ensures early diagnosis of recurrent or metastatic disease so that second-line therapy can be started.

Rationale:Primary seminal vesicle adenocarcinoma (PSVA) is an extremely rare malignancy that should be carefully differentiated from cancer originating in the prostate, colon or bladder. Without standard guidelines, radical resection is considered a mainstay treatment, providing the best pro

A case of primary seminal vesicle carcinoma is reported. The tumor was a CA125-producing adenocarcinoma consisting of fine papillary-tubular, intricate branching or anastomosing glandular structures and was composed of small cuboidal, but occasionally hobnailed, cells with mostly clear, but occasionally granular, cytoplasm. Some tumor cells showed evidence of secretion of seromucinous materials into the interpapillary and cystic space. Immunohistochemically, almost half of the tumor cells expressed a positive reaction with anti-CA125, a common serological marker for ovarian epithelial carcinomas; however, no tumor cells expressed any other serological tumor markers such as carcinoembryonic antigen, alpha-fetoprotein, human chorionic gonadotropin, prostatic specific acid phosphatase, or prostatic specific antigen. The patient showed a high level of serological CA125, which fluctuated parallel with the growth, removal and recurrence of the tumor. The morphological and immunohistochemical findings suggested a close relationship between the present tumor and clear cell carcinoma of the ovary, which is thought to be of a Müllerian-Wolfian duct origin.

Primary seminal vesicle (SV) adenocarcinoma is a rare tumor. A small amount of data about the role of imaging to detect tumor recurrence is available. We report the case of a 58-year-old patient with primary SV clear-cell well-differentiated adenocarcinoma. Clinical and instrumental examinations were negative for the 32 months after treatments when computed tomography scan, [(18)F]fluoro-D-glucose positron emission tomography/computed tomography and pelvic magnetic resonance imaging showed the appearance of a lesion in the left perineal muscle suspected for recurrence. Patient was symptomless. Cytology of the suspected lesion confirmed SV adenocarcinoma recurrence. The combined approach, using radiological and nuclear medicine techniques, seems to be effective in the follow-up of SV adenocarcinoma. Technological advances, together with awareness of this rare tumor, have the potential of improving patients outcomes not only by providing earlier detection and accurate staging, but also by detecting recurrence and thereby avoiding delays and therapeutic dilemmas.

Primary adenocarcinoma of the seminal vesicles is an extremely rare neoplasm. Because prompt diagnosis and treatment are associated with improved long-term survival, accurate recognition of this neoplasm is important, particularly when evaluating limited biopsy material. Immunohistochemistry can be used to rule out neoplasms that commonly invade the seminal vesicles, such as prostatic adenocarcinoma. Previous reports have shown that seminal vesicle adenocarcinoma (SVCA) is negative for prostate-specific antigen (PSA) and prostate-specific acid phosphatase (PAP); however, little else is known of its immunophenotype. Consequently, we evaluated the utility of cancer antigen 125 (CA-125) and cytokeratin (CK) subsets 7 and 20 for distinguishing SVCA from other neoplasms that enter the differential diagnosis. Four cases of SVCA-three cases of bladder adenocarcinoma and a rare case of adenocarcinoma arising in a mullerian duct cyst-were immunostained for CA-125, CK7, and CK20. Three of four cases of SVCA were CA-125 positive and CK7 positive. All four cases were CK20 negative. All bladder adenocarcinomas and the mullerian duct cyst adenocarcinoma were CK7 positive and negative for CA-125 and CK20. In addition, CA-125 immunostaining was performed in neoplasms that commonly invade the seminal vesicles, including prostatic adenocarcinoma (n = 40), bladder transitional cell carcinoma (n = 32), and rectal adenocarcinoma (n = 10), and all were negative for this antigen. In conclusion, the present study has shown that the CK7-positive, CK20-negative, CA-125-positive, PSA/PAP-negative immunophenotype of papillary SVCA is unique and can be used in conjunction with histomorphology to distinguish it from other tumors that enter the differential diagnosis, including prostatic adenocarcinoma (CA-125 negative, PSA/PAP positive), bladder transitional cell carcinoma (CK20 positive, CA-125 negative), rectal adenocarcinoma (CA-125 negative, CK7 negative, CK20 positive), bladder adenocarcinoma (CA-125 negative), and adenocarcinoma arising in a mullerian duct cyst (CA-125 negative).

The origin of chemically induced male accessory sex gland tumors was studied in Lobund-Wistar rats. Rats were treated at the age of 3 months with a single intravenous injection of 30 mg N-nitrosomethylurea (NMU)/kg body weight and given subcutaneous silastic implants filled with 40 mg testosterone propionate. Previous reports described a high incidence of prostate carcinomas in these rats with this treatment protocol. Additional animal groups included untreated controls, rats that received only an injection of 30 mg NMU/kg, and rats that were subjected to ablation of the seminal vesicle lobes prior to the treatment with NMU and testosterone. Three to 14 rats per group were sacrificed 4 to 10 months after NMU treatment and all remaining rats after 12 months. Twenty-four additional rats died or became moribund during the study. All rats were necropsied and the dorsolateral and ventral prostate and seminal vesicles with coagulating gland (anterior prostate) were examined histologically according to a standardized protocol. Lesions detected included atypical hyperplasia in all glands (resembling prostate intraepithelial neoplasia of human beings), adenomas in seminal vesicles only, and early carcinomas and adenocarcinomas in seminal vesicles and coagulating gland. Early carcinomas of the seminal vesicle, microscopically small and with invasion of the lamina propria and/or tunica muscularis, were detected as rapidly as 4 months after treatment. The vast majority (>95%) of the grossly visible nodules/masses originated from the seminal vesicles. Testosterone treatment enhanced occurrence and increased the incidence of all lesions, particularly of seminal vesicle adenocarcinomas, from 30% (7/23) to 64% (21/33). Coagulating gland tumors were found in 21% (7/33) of the rats. Ablation of the seminal vesicle lobes reduced the incidence of seminal vesicle adenocarcinomas to 11% (3/29), and these tumors arose from tissues remaining within the parenchyma of the seminal vesicle/prostate complex after ablation. Thus, NMU-induced and testosterone-promoted male sex gland tumors of the Lobund-Wistar rat arise almost exclusively in the seminal vesicles and coagulating gland (anterior prostate), are highly invasive in seminal vesicles before attaining a grossly visible size, and progress rapidly within 4 months, spreading to adjacent tissues and other organs.

Introducción: El adenocarcinoma primario de la vesícula seminal es una condición extremadamente rara. Se han descrito algunos casos en relación con quistes congénitos de la vesícula seminal, que a menudo se asocian también con agenesia o disgenesia renal ipsilateral. La rareza de este tipo de lesiones dificulta la planificación de un planteamiento quirúrgico reglado de las mismas, aunque habitualmente se tratan mediante exéresis simple o exenteración, según el estadio de las mismas al comienzo. Material y métodos: Presentamos una nueva técnica quirúrgica, consistente en vesiculectomía radical asociada a prostatectomía parcial laparoscópica (segmentaria total) de la zona central para tratar con éxito un adenocarcinoma primario de vesícula seminal en un varón joven, al que se le detectó por un estudio de azoospermia. Resultados: El estudio de imagen mediante resonancia magnética (RM) con difusión y la biopsia transrectal de la masa permitió una evaluación preoperatoria minuciosa del caso, confirmando malignidad y la precocidad de la lesión. El abordaje laparoscópico permitió llevar a cabo linfadenectomía pélvica y exéresis transperitoneal, incluyendo la zona central prostática y suturando la cara posterior de la uretra a la altura del ápex prostático. La lesión quística seminal confirmó en su pared un adenocarcinoma de células claras infiltrante, y el segmento prostático de la glándula central un adenocarcinoma no invasivo en la luz del conducto eyaculador con crecimiento in situ. Así, el espécimen quirúrgico permitió la exéresis radical con márgenes negativos, garantizando el carácter de cirugía mínimamente invasiva, con preservación de la continencia y de la erección. Conclusión: Se describe un nuevo abordaje integral para el planteamiento quirúrgico radical del adenocarcinoma primario de vesícula seminal localizado. A pesar de su carácter excepcional, el caso permite llevar a cabo una doble reflexión: a) el estudio de difusión con RM puede sugerir el diagnóstico de malignidad en este tipo de lesiones; y b) el tratamiento quirúrgico radical debe incluir la exéresis de la porción central de la glándula prostática. Introduction: Primary adenocarcinoma of the seminal vesicle is an extremely rare condition. Some cases have been described in relation to congenital seminal vesicle cysts, which is often also associated with agenesia or ipsilateral renal disgenesia. The rareness of this type of lesions makes it difficult to plan a regulated surgical approach for them, although they are often treated by simple exeresis or exenteration, depending on their stage at the beginning. Materials and methods: We present a new surgical technique that consists of radical vesiculectomy associated with laparoscopic partial prostatectomy (total segmentary) of the central area to successfully treat primary seminal vesicle adenocarcinoma in a young man who was diagnosed through an azoospermia study. Results: A study of the scan (MRI) with diffusion and the transrectal biopsy of the mass allowed us to make a thorough preoperative evaluation of the case, confirming the malignity and precociousness of the lesion. The laparoscopic approach allowed us to perform a pelvic lymphadenectomy and transperitoneal exeresis, including the central prostate area and suture of the posterior face of the urethra at the height of the apex of the prostate. The wall of the seminal cyst lesion confirmed infiltrating clear cell adenocarcinoma and non-invasive adenocarcinoma in the prostate segment of the central gland in the light of the ejaculatory conduct with "in situ" growth. Thus, the surgical specimen allowed radical exeresis with negative margins, guaranteeing minimally invasive surgery with preservation of continence and erection. Conclusion: We describe a new integral approach for the radical surgery of localized primary adenocarcinoma of the seminal vesicle. Despite its exceptional nature, the case allowed for a double reflection: a) The study of diffusion with MRI may suggest the diagnosis of malignity in this type of lesions; and b) Radical surgical treatment must include exeresis of the central portion of the prostate gland.

We describe the case of a 48-year-old male with primary seminal vesicle carcinoma. Although most malignant lesions involving the seminal vesicles are the result of secondary spread from other tumors, primary seminal vesicle carcinoma must be considered in the differential diagnosis, as the prognosis for this condition is dismal. Magnetic resonance imaging plays a crucial role in assessment, as it can exquisitely depict the anatomy of this region and define the extent of a seminal vesicle lesion.

Summary 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.

We provide an overview of seminal vesicle carcinoma, a rare entity that is difficult to diagnose and traditionally has been associated with a poor prognosis.A literature search for seminal vesicle carcinoma was performed, and current concepts related to the diagnosis and clinical management were reviewed. Two unpublished additional cases recently treated at our institution were added to the international experience. Special attention was given to new developments in diagnostic methods. Histopathological changes and biomarker criteria are provided to allow accurate diagnosis of this condition.Early diagnosis of seminal vesicle carcinoma has often been difficult due to a lack of immunohistochemical markers that distinguish this entity from invasive adenocarcinoma of adjacent organs. A total of 49 documented cases of seminal vesicle carcinoma in men between 19 and 90 years old has been reported in the current literature. Two additional cases that were diagnosed and treated at our institution are incorporated into this review. Recently the tissue marker CA 125 has substantially increased the accurate diagnosis of seminal vesicle carcinoma. In addition, increased serum CA 125 in patients with this disease has been reported and serum levels correlate well with the clinical course of the disease. Radical surgery in combination with adjuvant radiotherapy or androgen deprivation has resulted in long-term palliation in some patients with advanced disease.Including seminal vesicle carcinoma in the differential diagnosis of lower urinary tract symptoms will improve detection. Improved imaging tools and the availability of a serum marker will undoubtedly enhance detection at the earliest stages. More defined histopathological criteria will allow diagnosis even with small biopsy specimens. Radical surgery appears to offer the best chance for cure but hormonal manipulation and radiotherapy seem to be effective as adjuvant treatment modalities.

A rare seminal vesicle adenocarcinoma was found in a 109-wk-old Fischer 344 (F344) rat. At necropsy, the right seminal vesicle was enlarged, containing a 15- × 18- ×18-mm mass. The neoplasm occupied almost the entire seminal vesicle lumen and consisted of epithelial cells arranged in papillary, glandular, and solid patterns. Tumor cells were larger than their normal counterparts in the seminal vesicles and had round nuclei and abundant cytoplasm. Clusters of macrophagelike cells with less abundant cytoplasm and indented nuclei were apparent in the lumina of the glandular structures formed by the tumor cells. No metastasis to other tissues or organs was observed. Immunohistochemically, tumor cells were positive for keratin and S-100, and the macrophagelike cells bound antibodies against vimentin and ED-1. Ultrastructurally, the tumor cells exhibited many small secretory granules, some microvilli, and intercellular junctions. The macrophagelike cells, in contrast, were characterized by lysosomes and abundant rough endoplasmic reticulum. Therefore, a diagnosis of seminal vesicle adenocarcinoma with intraluminal macrophage infiltration was made. This is the first case report of such a seminal vesicle tumor in an F344 rat.

We report a rare case of isolated penile metastasis from seminal vesicle adenocarcinoma associated with ipsilateral renal agenesis in a 62-year-old man. Imaging studies confirmed seminal vesicle origin, and biopsy revealed a papillary mucin-secreting adenocarcinoma, with cytokeratin 20 positivity and prostate-specific antigen negativity. The sigmoidoscopy and metastatic workup findings were normal. The patient received six cycles of 5-fluorouracil, leucovorin, and oxaliplatin chemotherapy and underwent bilateral orchiectomy. The patient was symptomatically better, and the penile swelling and seminal vesicle mass had regressed considerably. He later developed multiple lung metastases and died of the disease.

検査所見, 病理所見, 免疫組織化学的染色所見から原発性精嚢腺癌と確診された41歳男性の症例を経験した. 本症例は尿中に多数の腺癌細胞が出現し, 諸検査の中で尿細胞診だけが悪性腫瘍の存在を示唆する陽性所見が続き, 細胞診が他臓器へ浸潤する前に発見されるきっかけとなった. 尿中に出現した異型細胞は核小体が明瞭な腺上皮系の細胞で, 核は偏在傾向が強く, 胞体は泡沫状, 多核白血球や組織球が多数認められる炎症性背景の中に, 辺縁明瞭な腫瘍細胞が平面的な細胞集団を形成する明細胞癌の特徴がみられた. 一部には乳頭状構造を有する細胞集団も認められたが, 腺管の形成は認められなかった. 手術材料の組織像は乳頭状腺癌で, 一部に明細胞癌の所見や靴鋲細胞の出現が認められた. 本症例は精嚢腺癌の組織発生を論ずるうえでも貴重な症例と考えられた. 尿中に出現する癌細胞の起源を的確に同定するために, 精管系上皮に由来する正常細胞あるいは腫瘍細胞の単に形態的な特徴だけではなく, 組織化学的に特徴的な反応を見い出す努力が, 今後必要であろう.

Strict criteria were applied to 12 cases of carcinoma of the seminal vesicle in the Mayo Clinic tumor registry. Diagnosis was carcinoma of the seminal vesicle if the neoplasm was a papillary or anaplastic carcinoma localized primarily to the seminal vesicle and no other primary tumors were demonstrated. In addition, some degree of mucin production was required, especially when prostatic involvement was present. Only 2 of our cases and 35 cases reported previously were judged acceptable or probable cases of carcinoma of the seminal vesicle.Prognosis for patients with this tumor is poor. A combination of extirpative surgery and hormonal therapy appears to provide the best opportunity for extended survival, although this remains to be proved.

Seminal vesicle (SV) adenocarcinoma is a rare and poorly understood malignancy. Symptoms are non-specific and prognosis is extremely poor. Herein we present a case report of a primary SV clear cell adenocarcinoma with bilateral orbital metastases at the time of initial presentation treated with multimodal therapy including radiotherapy and multi-drug chemotherapy.