Abstract
IntroductionPrimary tumors of seminal vesicles are rare and only a few cases have been reported. Diagnosis is difficult due to the absence of early clinical signs. Prognosis is generally poor.Case presentationWe present the case of a 70-year-old Caucasian man with a seminal vesicle mass and concomitant lymph node metastasis detected by computed tomography and body positron emission tomography/low-dose computed tomography scan carried out for evaluation of Lambert Eaton syndrome. Transrectal ultrasound-guided biopsy showed a poorly differented neuroendocrine carcinoma with an immunhistochemical profile similar to small cell lung cancer. Following chemotherapy the disease was stable and active surveillance was initiated.ConclusionsLambert Eaton syndrome may be the initial symptom of a seminal vesicle mass. Diagnosis needs to be obtained by transrectal biopsy and chemotherapy may delay progression of the tumor.
Highlights
Primary tumors of seminal vesicles are rare and only a few cases have been reported
Lambert Eaton syndrome may be the initial symptom of a seminal vesicle mass
Diagnosis needs to be obtained by transrectal biopsy and chemotherapy may delay progression of the tumor
Summary
Primary tumors of seminal vesicles are extremely rare. A total of 51 documented cases of seminal vesicle carcinoma in men between the ages of 19 and 90 years old have been reported in the literature [1]. Seminal vesicle neoplasms are often difficult to diagnose, generally presenting as a retrovesical mass that can be detected by digital rectal examination and. Prognosis of patients with a seminal vesicle tumor is generally poor. Whole body positron emission tomography (PET)/ low-dose CT scan (Figure 1) revealed a 2.3 × 1.9 cm tumor of the right seminal vesicle presenting as an irregular circumscribed mass. Following the imaging results another transrectal ultrasound-guided 10 core biopsy of the suspicious right seminal vesicle and the right prostate gland was performed.The histological findings of the biopsy of the right seminal vesicle showed a poorly differentiated neuroendocrine carcinoma with immunohistochemistry similar to SCLC. Pyridostigmine bromide 60 mg twice daily and 90 mg during the night for the myasthenic symptoms were initiated With this medication the pronounced weakness that he initially presented with declined. In case of impairment of the clinical symptoms, monotherapy with etoposide would be initiated
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