Letter to the Editor
Management of primary carcinoma of the seminal vesicle
Tratamiento del carcinoma primario de la vesícula seminal
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Favaretto, M.C. Ercolani, R. Sánchez-Salas, P. Validire, E. Barret, X. Cathelineau" "autores" => array:6 [ 0 => array:3 [ "nombre" => "R.L." "apellidos" => "Favaretto" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "M.C." "apellidos" => "Ercolani" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "R." "apellidos" => "Sánchez-Salas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "P." "apellidos" => "Validire" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 4 => array:4 [ "nombre" => "E." "apellidos" => "Barret" "email" => array:1 [ 0 => "eric.barret@imm.fr" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 5 => array:3 [ "nombre" => "X." "apellidos" => "Cathelineau" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Departamento de Urología, Instituto Montsouris, Universidad Paris Descartes, París, France" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Departamento de Patología, Instituto Montsouris, Universidad Paris Descartes, París, France" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tratamiento del carcinoma primario de la vesícula seminal" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 711 "Ancho" => 913 "Tamanyo" => 168875 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Hematoxylin and eosin stain at 20× magnification. Mucinous adenocarcinoma defined by the presence of large deposits of mucinous material (arrows).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Adenocarcinoma, the most common histology found in primary malignant tumors of the seminal vesicle (SV),<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> usually presents as a locally advanced disease due to a paucity of symptoms and signs at earlier stages. We recently treated a 62-year-old man with a three-month-history of hematospermia and a PSA of 1.92<span class="elsevierStyleHsp" style=""></span>ng/ml. On digital rectal examination, an abnormality was noted, and an enlarged right SV was confirmed by ultrasound. MRI demonstrated a 10-cm right SV with a hemorrhagic component that compressed the prostate and bladder. No lymph node enlargement was noted. Transrectal ultrasound-guided biopsy of the SV was histopathologically compatible with a mucinous adenocarcinoma. Prostate biopsy showed the same pathologic characteristics, suggesting secondary invasion. Robotic prostatovesiculectomy with bilateral pelvic lymphadenectomy was intended. Due to tumor size and procedure difficulty, the operation was converted to an open approach and completed successfully. There were no perioperative complications. Final pathology confirmed a 7-cm primary tumor (172<span class="elsevierStyleHsp" style=""></span>g) of the SV with a histological diagnosis of mucinous adenocarcinoma with papillary architecture (<a class="elsevierStyleCrossRefs" href="#fig0005">Figs. 1 and 2</a>). Immunohistochemically, the tumor was positive for CA 125 and CK 7, and negative for PSA and PAP. The tumor was invading right and left prostatic lobes, and positive surgical margins were identified. A total of 23 pelvic lymph nodes resected were negative for metastasis. At the last follow-up visit, the patient was doing well with a PSA of 0.01<span class="elsevierStyleHsp" style=""></span>ng/ml and no signs of disease progression. Adjuvant treatment (hormone therapy and radiotherapy) was proposed.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Primary carcinoma of the SV is difficult to diagnose and differentiate from tumors of the prostate, bladder and rectum invading the SV. Even with advances in imaging allowing increased sensitivity for detection of SV abnormalities and the use of immunohistochemical studies, patients with SVC are often diagnosed in late stage and survival outcomes are poor.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> As the tumor has no pathognomonic features, diagnosis is accomplished through a combination of gross specimen analysis, pre-operative imaging evaluation (no bladder, colon, prostate, or rectal abnormalities on CT or MRI), and immunohistochemical assays.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Early diagnosis and aggressive surgical treatment seem to be the only way to improve survival.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> However, because of the rarity of the disease, guidelines are not available for how to best manage this clinically aggressive entity. Treatment strategies have focused on surgical excision of the tumor.<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4–6</span></a> Extensive pelvic lymph node dissection is also recommended. Only tumors without prostatic involvement might be treated with local excision or vesiculectomy alone, a clinical scenario that rarely occurs.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows the cases reported in the last 10 years with emphasis on treatment used.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,6–8,10</span></a> In patients with positive surgical margins, adjuvant radiotherapy might have a role in controlling the disease locally.<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6–8</span></a> Adjuvant hormonal therapy has also been used.<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4,7,8</span></a> Chemotherapy has been utilized, but results have been disappointing.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Considering surveillance after treatment of the primary disease, CA-125 seems to play an important role in the diagnosis and can be used as a serological marker to monitor treatment response.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,9</span></a></p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">We confirm that primary carcinoma of the SV is a rare disease with typically late diagnosis. Biomarkers and clinical vigilance are needed to change the historically poor prognosis of this malignancy. Guidelines for management are still not available, but based on the limited published data, we strongly believe that aggressive surgical treatment with wide extirpation of the tumor seems to provide the best survival benefit.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Please cite this article as: Favaretto RL, et al. Tratamiento del carcinoma primario de la vesícula seminal. Actas Urol Esp. 2012;36:67–8.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 741 "Ancho" => 911 "Tamanyo" => 151150 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Operative specimen of a small prostate (P) and a very large abnormally appearing right seminal vesicle (S).</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 711 "Ancho" => 913 "Tamanyo" => 168875 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Hematoxylin and eosin stain at 20× magnification. Mucinous adenocarcinoma defined by the presence of large deposits of mucinous material (arrows).</p>" ] ] 2 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Reference \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Year \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Treatment \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Thiel et al.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2002 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Prostatovesiculectomy \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Thiel et al.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2002 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Excision seminal vesicle \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Egevad et al.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2007 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Neoadjuvant XRT<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>cystoprostatectomy \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lee et al.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2007 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Excision seminal vesicle and partial cystectomy \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Thyavihally et al.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2007 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Chemotherapy<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>hormonal blockage \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mohring et al.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2009 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Prostatovesiculectomy \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Angulo et al.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2011 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Vesiculectomy and partial prostatectomy \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Current report \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2012 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Prostatovesiculectomy<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>hormonal blockage<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>XRT 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2023 March | 1 | 1 | 2 |
| 2018 February | 7 | 8 | 15 |
| 2018 January | 1 | 4 | 5 |
| 2017 December | 8 | 1 | 9 |
| 2017 November | 5 | 5 | 10 |
| 2017 October | 11 | 2 | 13 |
| 2017 September | 7 | 4 | 11 |
| 2017 August | 25 | 5 | 30 |
| 2017 July | 24 | 5 | 29 |
| 2017 June | 13 | 8 | 21 |
| 2017 May | 12 | 5 | 17 |
| 2017 April | 13 | 3 | 16 |
| 2017 March | 18 | 14 | 32 |
| 2017 February | 29 | 6 | 35 |
| 2017 January | 22 | 6 | 28 |
| 2016 December | 36 | 10 | 46 |
| 2016 November | 51 | 7 | 58 |
| 2016 October | 32 | 6 | 38 |
| 2016 September | 31 | 9 | 40 |
| 2016 August | 22 | 6 | 28 |
| 2016 July | 19 | 1 | 20 |
| 2016 June | 36 | 10 | 46 |
| 2016 May | 19 | 13 | 32 |
| 2016 April | 25 | 16 | 41 |
| 2016 March | 22 | 15 | 37 |
| 2016 February | 28 | 18 | 46 |
| 2016 January | 26 | 19 | 45 |
| 2015 December | 21 | 10 | 31 |
| 2015 November | 15 | 12 | 27 |
| 2015 October | 28 | 15 | 43 |
| 2015 September | 28 | 20 | 48 |
| 2015 August | 20 | 3 | 23 |
| 2015 July | 15 | 6 | 21 |
| 2015 June | 3 | 5 | 8 |
| 2015 May | 11 | 5 | 16 |
| 2015 April | 15 | 9 | 24 |
| 2015 March | 27 | 2 | 29 |
| 2015 February | 11 | 0 | 11 |
| 2015 January | 35 | 3 | 38 |
| 2014 December | 66 | 6 | 72 |
| 2014 November | 38 | 2 | 40 |
| 2014 October | 36 | 9 | 45 |
| 2014 September | 45 | 6 | 51 |
| 2014 August | 28 | 1 | 29 |
| 2014 July | 38 | 3 | 41 |
| 2014 June | 17 | 3 | 20 |
| 2014 May | 13 | 5 | 18 |
| 2014 April | 12 | 3 | 15 |
| 2014 March | 18 | 4 | 22 |
| 2014 February | 17 | 2 | 19 |
| 2014 January | 22 | 1 | 23 |
| 2013 December | 9 | 2 | 11 |
| 2013 November | 12 | 2 | 14 |
| 2013 October | 13 | 4 | 17 |
| 2013 September | 3 | 1 | 4 |
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