Schwannoma of Seminal Vesicle: A Case Report

Seminal vesicle neoplasms are extremely rare. Schwannoma is a benign tumor of the peripherical nerve sheath composed of Schwann cells. Most of these tumors are silent and become symptomatic with compression of adjacent organs and nerves. We present a case of a 72-year-old man who presented with a several months history of predominant storage lower urinary tract symptoms and painful ejaculation. Prostate-specific antigen (PSA) was within normal ranges, and imaging documented a retrovesical nodular lesion adjacent to the right seminal vesicle with 5 cm in width. We successfully performed a robotic-assisted laparoscopic surgery to excise the lesion. Anatomopathological analysis revealed a schwannoma.

Laparoscopic surgery combined with the double-J tube implantation for the rare cystic-solid schwannoma of seminal vesicle: A Case Report and Literature Review

RATIONALE

Schwannoma is common in young and middle-aged people and occurs in the head, neck, posterior mediastinum, and retroperitoneal. Schwannoma, on the other hand, is a rare occurrence in the seminal vesicle. Early diagnosis and treatment are crucial since the disease can cause lower abdominal pain, nocturia, frequent urination, blood sperm, and other symptoms. There is no standard diagnostic or treatment guideline for seminal vesicle schwannomas currently. Therefore, the treatment experience relies on the few cases reported throughout the world.

PATIENT CONCERNS

A 45-year-old male patient discovered that the tumor beside the right side spermatophore is bigger than 3 years ago.

DIAGNOSIS

Schwannoma of seminal vesicle.

INTERVENTIONS

Ureter double-J tube implantation and laparoscopic surgery for schwannoma of seminal vesicle.

OUTCOMES

The operation process went smoothly. And the patient was no discomfort after half a year.

CONCLUSION

Schwannoma of the seminal vesicle is very rare in the clinic, and the imaging examination was not conclusive. The diagnosis mainly depends on pathological results. Surgical resection is the best treatment method for schwannoma. In surgery for schwannoma of seminal vesicle, combined with the ureter double-J tube implantation are many benefits. This case is an excellent example of the seminal vesicle schwannomas.

A giant retrovesical cystic mass: A rarest of rare with a management dilemma

A 32-year-old man investigated for subfertility and bladder outlet obstruction. He had a palpable pelvic mass and computerized tomography (CT) pelvis demonstrated that a large cystic mass (15cm) arising from right side seminal vesicle, and another small cyst from left side seminal vesicle with unilateral hydroureteronephrosis. Following a futile attempt of endoscopic drainage, mass was excised in toto via lower midline laparotomy. Pathological examination and immunocytochemistry confirmed the mass to be an extremely rare seminal vesicle Schwannoma. To our knowledge, there are few unilateral seminal vesicle schwannomas reported in literature published in English language up to date.

Case report of seminal vesical schwannoma treated with conservative strategy

RATIONALE

Schwannoma is a benign peripheral nerve sheath tumor composed of Schwann cells and caused by genetic mutation or deletion. It rarely occurs in seminal vesicles. The optimal therapic strategy for asymptomatic cases is still unclear.

PATIENT CONCERNS

A 42-year-old man presented no clinical symptoms. A mass in his left seminal vesicle was found incidentally in a computed tomography scan and transrectal ultrasound-guided biopsy revealed the mass was schwannoma.

DIAGNOSIS

The patient was diagnosed as schwannoma of the seminal vesicle with no significant extension to the surrounding tissues.

INTERVENTIONS

The patient underwent computed tomography or magnetic resonance imaging scans periodically to estimate the alteration of the lesion and further strategy.

OUTCOMES

After 20-month follow-up, computed tomography scans showed no significant alteration to the lesion and no clinical symptoms were reported by the patient.

LESSONS

Conservative strategy might be an effective treatment option for asymptomatic patients with seminal vesical schwannoma. The period of follow-up depends on the size of the tumor.

Multiple schwannoma of the seminal vesicle: A case report

RATIONALE

Schwannomas of the seminal vesicles are extremely rare, and only cases of single seminal vesicle schwannomas have been reported. Here, we report a case of multiple schwannoma of the seminal vesicle.

PATIENT CONCERNS

We report a rare case of multiple schwannoma of the seminal vesicle that occurred in a 48-year-old man during physical examination. Multiple mixed masses in the left region of the seminal vesicle were documented with transrectal ultrasonography and magnetic resonance imaging. The patient presented no clinical symptoms, no family history of the disease and no history of genetic disease.

DIAGNOSIS

Postoperative pathology revealed a diagnosis of seminal vesical schwannoma.

INTERVENTIONS

The patient underwent robotic-assisted laparoscopic surgery to remove the mass.

OUTCOMES

The patient recovered rapidly and the length of hospitalization was 6 days after operation. At present, there is no recurrence in 10 month follow up.

LESSONS

Whether benign or malignant, single or multiple, schwannomas still need to be diagnosed by pathology because of the limitations of examination methods. Surgical resection is still the preferred treatment.

Mesenchymal tumors of the prostate

Mesenchymal tumors of the prostate are rare but often cause considerable diagnostic difficulty when encountered. These may be either benign or malignant and can arise within the prostate gland or in adjacent tissues. This review covers prostatic stromal proliferations (prostatic stromal tumor of uncertain malignant potential and stromal sarcoma), solitary fibrous tumor, myofibroblastic proliferations, smooth muscle neoplasms (leiomyoma and leiomyosarcoma), gastrointestinal stromal tumor, schwannoma, rhabdomyosarcoma, sarcomatoid carcinoma, postradiation sarcoma, and mixed epithelial stromal tumor of the seminal vesicle. Differential diagnostic considerations are emphasized, including descriptions of helpful histological and/or clinical clues and the use of adjuvant diagnostic techniques.

Seminal vesicle schwannoma presenting with left hydroureteronephrosis

We report a very rare case of seminal vesicle schwannoma in a 50-year-old male, with left hydroureteronephrosis. Only five cases of seminal vesicle schwannomas have been reported in medical literature until date.