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Seminal Vesicle Carcinoma
Etiology and Pathology of the seminal vesicle carcinoma
The very rare primary seminal vesicle carcinoma is an adenocarcinoma, which does not express PSA. Typically, primary seminal vesicle carcinomas express CEA and CA-125. Patients are usually over 50 years old. Much more common is the infiltration of the seminal vesicles by undifferentiated carcinomas of the bladder, the prostate or rectum. Rarities are primary sarcomas, carcinoids, cystosarcoma phylloides and seminomas of the seminal vesicles (Thiel and Effert, 2002).
Signs and Symptoms
Lower abdominal and perineal pain, hematospermia (blood in semen) or hydronephrosis.
Diagnostik Workup of Tumors of the Seminal Vesicles
Transrectal ultrasound with biopsy of the seminal vesicle tumor and of the prostate. CT scan or magnetic resonance imaging of abdomen and pelvis. Chest X-ray or CT thorax. Tumor marker: PSA, CEA and CA-125.
Differential Diagnosis of Seminal Vesicle Tumors
Malignant lesions of the seminal vesicles are very rare. Frequent are benign lesions such as adenoma, cystadenoma, fibroids, cysts or abscess...
Treatment of Seminal Vesicle Carcinoma
Standard treatment is radical cystoprostatectomy, in retrospective series often combined with adjuvant radiotherapy. Complete extenteration may be necessary, if infiltration of the rectum is present. The primary seminal vesicle carcinoma grows hormone-dependent and is responsive to anti-androgen hormone therapy.
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References
Thiel und Effert 2002 THIEL, R. ; EFFERT, P.: Primary adenocarcinoma of the seminal vesicles.In: J Urol
168 (2002), Nr. 5, S. 1891–6
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