Mizuno Nobuhiko, Fujikawa Naoya, Hayashi Narihiko, Murakami Takayuki, Suzuki Kotaro, Ikeda Ichiro
Department of Urology, Yokohama Minamikyousai Hospital, Yokohama, Japan.
Nihon Hinyokika Gakkai Zasshi. 2012 Nov;103(6):704-7. doi: 10.5980/jpnjurol.103.704.
We reported a case of primary seminal vesicle cancer, detected by FDG-PET/CT. A 65-year-old man with constipation and appetite loss was admitted to our hospital. An ultrasound examination revealed evidence of bilateral hydronephrosis. He was diagnosed as acute post renal failure, and nephrostomy was done. CT and MRI showed a solid mass in the area of seminal vesicle. He underwent transrectal core biopsy, which histologically showed poorly differentiated adenocarcinoma. Immunohistochemistry showed the tumor to be CA125 positive, CEA positive and CK7 positive but PSA negative. FDG-PET/CT revealed an increased uptake of FDG only in the area of seminal vesicle. Serum CA125 was elevated and PSA stayed within normal limit. Primaly rectal carcinoma was ruled out by colonoscopy. The result of transperineal prostate biopsy was negative. We diagnosed him as suffering from primary seminal vesicle carcinoma. Anti-androgen blockade and radiotherapy to whole pelvis were performed, and serum CA125 level was improved. But, 6 months later serum CA125 re-elevated and 19 months later multiple liver metastases were noted. The patient received two cycles of docetaxel and cisplatin chemotherapy, however he developed pulmonaly embolism and rectal bleeding by tumor invasion and he died of his disease 22 months after the diagnosis.
我们报告了一例通过氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描(FDG-PET/CT)检测出的原发性精囊癌病例。一名65岁男性因便秘和食欲减退入院。超声检查显示双侧肾积水。他被诊断为急性肾后性肾衰竭,并进行了肾造瘘术。CT和MRI显示精囊区域有一个实性肿块。他接受了经直肠穿刺活检,组织学显示为低分化腺癌。免疫组化显示肿瘤CA125阳性、癌胚抗原(CEA)阳性、细胞角蛋白7(CK7)阳性但前列腺特异性抗原(PSA)阴性。FDG-PET/CT显示仅精囊区域有FDG摄取增加。血清CA125升高而PSA保持在正常范围内。结肠镜检查排除了原发性直肠癌。经会阴前列腺活检结果为阴性。我们诊断他患有原发性精囊癌。进行了抗雄激素阻断和全盆腔放疗,血清CA125水平有所改善。但是,6个月后血清CA125再次升高,19个月后发现多处肝转移。患者接受了两个周期的多西他赛和顺铂化疗,然而他出现了肺栓塞和因肿瘤侵犯导致的直肠出血,并在诊断后22个月死于该疾病。