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Seminal Vesicle Metastasis of Renal Cell Carcinoma
Images in Clinical Urology Seminal Vesicle Metastasis of Renal Cell Carcinoma Kyosuke Matsuzaki, Yutaka Yasunaga, Satoko Fukuda, and Toshitsugu Oka We present an unusual magnetic resonance imaging finding of a 70-year-old man with the seminal vesicle tumor. The patient underwent radical nephrectomy for renal cell carcinoma 4 years ago. Laboratory data, including prostaticspecific antigen, ranged within normal limits. Transrectal needle biopsy disclosed a clear cell carcinoma, which was compatible with the original renal cell cancer. Vesiclectomy was performed. Pathohistologic examination confirmed a metastatic renal cell carcinoma of the seminal vesicle. UROLOGY 74: 1017–1018, 2009. © 2009 Elsevier Inc.
Figure 1. (A) Magnetic resonance imaging (T2-weighted) revealing a tumor in the seminal vesicle with irregular edge. (B) Transrectal ultrasonography showing swelling of the right seminal vesicle with irregular echogenic pattern.
From the Department of Urology, National Hospital Organization Osaka Medical Center, Osaka, Japan Reprint requests: Yutaka Yasunaga, M.D., Ph.D., Department of Urology, National Hospital Organization Osaka Medical Center, Osaka city, Osaka, Japan. E-mail: [email protected] Submitted: March 27, 2009, accepted (with revisions): April 22, 2009
© 2009 Elsevier Inc. All Rights Reserved
Figure 2. (A) A macroscopic view of the excised tumor of the right seminal vesicle appearing yellowish and as a solid mass. (B) A microscopic view of the tumor showing a clear cell carcinoma, which is compatible with the original renal cancer.
A
follow-up CT scan of a 70-year-old Japanese man who underwent left radical nephrectomy for renal cell carcinoma 4 years prior (clear cell carcinoma, G2, pT2N0M0) revealed an enlargement of the right seminal vesicle. Subsequent magnetic resonance imaging confirmed the enhancement of the semi0090-4295/09/$34.00 doi:10.1016/j.urology.2009.04.058
1017
nal vesicle with an irregular-edged shape, 16 mm in size, suggesting a seminal vesicle tumor (Fig. 1A). Digital rectal examination showed no abnormal findings in the seminal vesicles and the prostate. Serum laboratory data, including prostatic specific antigen, were within normal range. Transrectal ultrasonography demonstrated swelling of the right seminal vesicle, with an irregular echogenic pattern (Fig. 1B). Needle biopsy was carried out. Histologic findings revealed clear cell carcinoma resembling the original renal cell cancer. The prostate that was also biopsied transrectally showed no tumor findings. Bilateral vesiclectomy was performed (Fig. 2A). Pathohistologic findings of the excised tumor confirmed the diagnosis of metastatic renal cell carcinoma in the right
1018
seminal vesicle (Fig. 2B). The patient has been alive with lung metastasis postoperatively. To our knowledge, only 2 cases of seminal vesicle metastasis of renal cell carcinoma have been reported,1,2 but the clinical information provided was limited. This is the first well-documented case presented with the precise preoperative diagnosis and operative findings. References 1. Yamamoto S, Mamiya Y, Noda K, et al. A case of metastasis to the seminal vesicle of renal cell carcinoma. Nippon Hinyokika Gakkai Zasshi. 1998;89:563-566. 2. Reisman Y, de Reijke TM. An unusual cause of irritable urinary bladder symptoms. Urol Int. 2001;66:225-226.
UROLOGY 74 (5), 2009
Figure 1. (A) Magnetic resonance imaging (T2-weighted) revealing a tumor in the seminal vesicle with irregular edge. (B) Transrectal ultrasonography showing swelling of the right seminal vesicle with irregular echogenic pattern.
From the Department of Urology, National Hospital Organization Osaka Medical Center, Osaka, Japan Reprint requests: Yutaka Yasunaga, M.D., Ph.D., Department of Urology, National Hospital Organization Osaka Medical Center, Osaka city, Osaka, Japan. E-mail: [email protected] Submitted: March 27, 2009, accepted (with revisions): April 22, 2009
© 2009 Elsevier Inc. All Rights Reserved
Figure 2. (A) A macroscopic view of the excised tumor of the right seminal vesicle appearing yellowish and as a solid mass. (B) A microscopic view of the tumor showing a clear cell carcinoma, which is compatible with the original renal cancer.
A
follow-up CT scan of a 70-year-old Japanese man who underwent left radical nephrectomy for renal cell carcinoma 4 years prior (clear cell carcinoma, G2, pT2N0M0) revealed an enlargement of the right seminal vesicle. Subsequent magnetic resonance imaging confirmed the enhancement of the semi0090-4295/09/$34.00 doi:10.1016/j.urology.2009.04.058
1017
nal vesicle with an irregular-edged shape, 16 mm in size, suggesting a seminal vesicle tumor (Fig. 1A). Digital rectal examination showed no abnormal findings in the seminal vesicles and the prostate. Serum laboratory data, including prostatic specific antigen, were within normal range. Transrectal ultrasonography demonstrated swelling of the right seminal vesicle, with an irregular echogenic pattern (Fig. 1B). Needle biopsy was carried out. Histologic findings revealed clear cell carcinoma resembling the original renal cell cancer. The prostate that was also biopsied transrectally showed no tumor findings. Bilateral vesiclectomy was performed (Fig. 2A). Pathohistologic findings of the excised tumor confirmed the diagnosis of metastatic renal cell carcinoma in the right
1018
seminal vesicle (Fig. 2B). The patient has been alive with lung metastasis postoperatively. To our knowledge, only 2 cases of seminal vesicle metastasis of renal cell carcinoma have been reported,1,2 but the clinical information provided was limited. This is the first well-documented case presented with the precise preoperative diagnosis and operative findings. References 1. Yamamoto S, Mamiya Y, Noda K, et al. A case of metastasis to the seminal vesicle of renal cell carcinoma. Nippon Hinyokika Gakkai Zasshi. 1998;89:563-566. 2. Reisman Y, de Reijke TM. An unusual cause of irritable urinary bladder symptoms. Urol Int. 2001;66:225-226.
UROLOGY 74 (5), 2009