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Seminal Vesicle Carcinoma

Etiology and Pathology of the seminal vesicle carcinoma

The sporadic 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 the 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.

Diagnostic 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 the abdomen and pelvis. Chest X-ray or CT thorax. Tumor markers: PSA, CEA and CA-125.

Differential Diagnosis of Seminal Vesicle Tumors

Malignant lesions of the seminal vesicles are rare. Benign lesions such as adenoma, cystadenoma, fibroids, cysts, or abscesses are more frequent.

Treatment of Seminal Vesicle Carcinoma

Standard treatment is radical cystoprostatectomy, in retrospective series often combined with adjuvant radiotherapy. Complete exenteration 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.

References

  Deutsche Version: Samenblasenkarzinom