Masses

Rarely, men are diagnosed with masses of the seminal vesicle. Pain, obstruction of adjacent organs, dysuria, hematuria, or hematospermia can occur (24). Since the masses are often indistinguishable from adjacent organs, serum prostate-specific antigen and car-cinoembryonic antigen can be helpful in determining if there is a prostatic or colorectal origin (24). Alternatively, an elevated serum CA125 is strongly suggestive of a primary seminal vesicle carcinoma (25). Most masses of the seminal vesicle are benign, such as papillary adenomas, cystadenoma, fibromas, and leiomyomas. Seminal vesicle tumors with malignant potential are exceedingly rare. Primary malignancies of the seminal vesicle such as adenocarcinoma (24), sarcoma (26), schwannoma (27), and squamous cell carcinoma (28) can occur and are probably best managed by aggressive extirpative surgery via either radical prostatectomy or cystoprostatectomy. While surgical excision is the primary form of therapy, radiotherapy and hormones have been used as adjuvant treatment (29-32). Regardless of treatment, the prognosis is poor (24).

To date there have been no reports of laparoscopic excision of the seminal vesicle for a primary malignancy.

0 0

Post a comment