Abstract
BackgroundPrimary leiomyosarcoma of the seminal vesicle is exceedingly rare.Case PresentationWe report a case of a 59-year-old man with tumour detected by rectal symptoms and ultrasonography. Computed tomography and magnetic resonance imaging suggested an origin in the right seminal vesicle. Transperineal biopsy of the tumour revealed leiomyosarcoma. A radical vesiculo-prostactectomy with bilateral pelvic lymphadenectomy was performed. Pathological examination showed a grade 2 leiomyosarcoma of the seminal vesicle. The patient received adjuvant radiotherapy. He developed distant metastases 29 months after diagnosis, and received chemotherapy. Metastatic disease was controlled by second-line gemcitabine-docetaxel combination. Fifty-one months after diagnosis of the primary tumour, and 22 months after the first metastases, the patient is alive with excellent performance status, and multiple asymptomatic stable lung and liver lesions.ConclusionsWe report the eighth case of primary leiomyosarcoma of the seminal vesicle and the first one with a so long follow-up.
Highlights
Primary leiomyosarcoma of the seminal vesicle is exceedingly rare.Case Presentation: We report a case of a 59-year-old man with tumour detected by rectal symptoms and ultrasonography
We report the eighth case of primary leiomyosarcoma of the seminal vesicle and the first one with a so long follow-up
Metastatic relapses occurred in the 3 patients with microscopically incomplete resection (2 cases) and/or high grade (2 cases) and/or tumour size superior to 5 cm (2 cases), suggesting that those sarcomas share prognostic features with soft tissue sarcomas (STS) arising from other sites
Summary
Less than 5% of soft tissue sarcomas (STS) arise from the genitourinary tract. Leiomyosarcomas of the seminal vesicle are exceedingly rare. Computed tomography (CT) of abdomen and pelvis revealed an 8-cm heterogeneous tumour predominantly located on the right side of the pelvis likely arising from the right seminal vesicle, reaching the median line and adherenting to the posterior bladder wall and the anterior rectal wall. The pathological macroscopic examination of the surgical resection specimen showed a small prostate (4.5 × 4 × 3 cm) and an 8 × 8 × 6.5 cm welllimited hard white-tan mass, centred on the right seminal vesicle, tangent to the prostate base, pushing the vas deferens, the prostate and the left seminal vesicle. A last visit, in February 2011, 51 months after diagnosis of the primary tumour, and 22 months after the first metastasis, the patient is alive with excellent performance status, without any symptom, and with multiple stable lung and liver lesions
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