Seminal vesicle cystadenomas are a benign subgroup of mixed epithelial and stromal tumors of the seminal vesicles.
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Epidemiology
Benign tumors of the seminal vesicles are very rare and so are cystadenomas 1.
Clinical presentation
Voiding difficulties or hematuria have been reported as clinical symptoms of seminal vesicle cystadenomas 1,2.
Diagnosis
The diagnosis of seminal vesicle cystadenomas is established by typical pathological or rather histological features.
Pathology
Macroscopic appearance
Grossly tumors have been described as well-circumscribed with a glistening or smooth surface and a multilocular cystic cut surface 3.
Microscopic appearance
Microscopically cystadenomas of the seminal vesicles are characterized by columnar or cuboid epithelial cells surrounded by a fibrous stroma 1,3.
Immunophenotype
Immunohistochemistry might express CA-125 but should be negative for prostate-specific antigen (PSA), carcinoembryonic antigen (CEA), CK20 3.
Radiographic features
CT
Computed tomography might depict a cystic or soft tissue mass located between the bladder and rectum arising from one of the seminal vesicles 1-5.
MRI
On prostate or pelvic MRI seminal vesicle, cystadenomas have been characterized as multiseptate and well-delineated cystic masses with a well-defined capsule 1,3,5.
Signal characteristics
- T1: mixed hyper and hypointense
- T2: hyperintense with hypointense capsule
- DWI: lack of diffusion restriction
- DCE (Gd): delayed enhancement of the tumor capsule
Radiology report
The radiological report should include a description of the following:
- location form and extent of the tumor
- invasive features
- relation to prostate bladder and sigmoid colon
Treatment and prognosis
The treatment of seminal vesicle cystadenomas includes laparoscopic or open surgical approaches 1, the first having the advantage of decreased rates in postoperative morbidity, shorter hospitalization and faster recovery than the latter 1. Recurrences may occur on incomplete excision 3.
History and etymology
The first case of a seminal vesicle cystadenoma was probably described by R Guiteras in 1894 2.
Differential diagnosis
Conditions that may be mimicking the clinical presentation or imaging appearance of seminal vesicle cystadenomas include 1,6:
- seminal vesicle cyst
- adenocarcinoma of the seminal vesicle
- mixed epithelial and stromal tumors
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