Malignant Seminal Vesicle Tumor

Primary malignant seminal vesicle tumors are rare; usually papillary adenocarcinoma or sarcoma. Adenocarcinoma >50y; sarcoma <50y. Secondary invasion from bladder in situ carcinoma/prostate/rectum/lymphoma is more common, making primary vs secondary distinction hard. Clinical: hematospermia, intermittent hematuria, urinary frequency, thick gelatinous material in urine. Large mass causes dysuria/urinary retention. Late: tenesmus, secondary epididymitis. Blood in stool = rectal invasion. DRE: irregular firm spindle mass above prostate, cystic/solid, may fuse with prostate. Markers: PSA/PAP/CEA negative; elevated CA125 suggests seminal vesicle cancer. Cystoscopy: trigone compressed/deformed/displaced. Imaging: B-ultrasound/CT defines tumor; seminal vesiculography shows filling defects/obstruction/deformity; IVU assesses ureter; transrectal US-guided biopsy. Bone metastases lytic. Pathology: papillary adenocarcinoma, undifferentiated with mucin. Treatment: small early = laparoscopic partial/total vesiculectomy; large = bilateral seminal vesicles + bladder/prostate/rectum (total pelvic exenteration). Late unresectable = surgery + radiation + endocrine; chemo generally ineffective.

Common Symptoms

Frequency; hematospermia; tenesmus; thick gelatinous urine; intermittent hematuria; cyst; dysuria/urinary retention

Causes and Pathogenesis

Etiology unknown. Mechanism: usually no complete capsule; mainly invades prostate/bladder, rarely rectum; regional node metastasis primary; late distant metastasis; bone metastases lytic.

Treatment

Drug, rehabilitation

Preventive Measures

No effective prevention; early diagnosis/treatment.

Department to Visit

It is recommended to visit the Urology department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.