O 10. Simple seminal vesicle metastatic cancer after surgery for rectal cancer: A case report

Objective: To discuss the diagnosis and therapy of seminal vesicle tumors.

Methods: A male patient who underwent sphincter-preserving surgery for rectal cancer five years ago was admitted to our hospital due to intermittent painless hematospermia for 6 months. Pelvic CT showed that seminal vesicle enlarged significantly. CEA was in normal range and PSA was slightly raised. He was had been diagnosed as seminal vesicle tumor before operation.

Results: Bilateral seminal vesiculectomy was performed. Pathological consideration revealed seminal vesicle moderately differentiated metastatic adenocarcinoma. The patients were discharged two weeks after operation. Follow-up was being performed.

Conclusions: Pathological examination + immunohistochemical staining is the only way to obtain a definitive diagnosis of seminal vesicle tumor. The immunohistochemistry results of patients with suspected seminal vesicle tumor were PSA- and PAP-negative, CEA could be slightly raised. Additionally, a positive CA 125 value maybe can be regarded as a predicting result. Rectal cancer usually displays a CK7 negative, CK20 positive immunophenotype; while CK7 positive and Ck20 negative reactivity generally appears in seminal vesicle tumor. Immunohistochemical results of this case are: CK20 focal positive, CDX-2 positive, VIllin positive. Since no rectal cancer recurrence and metastasis had been found before operation, bilateral seminal vesiculectomy was chosen. The postoperative effect needs to be observed during follow-up.