Elmer-DeWitt Molly A, Gill Bradley C, Unnikrishnan Raman, Stephenson Andrew J
Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.
Lerner College of Medicine, Education Institute, Cleveland Clinic, Cleveland, OH, USA.
Transl Androl Urol. 2017 Dec;6(6):1184-1186. doi: 10.21037/tau.2017.10.03.
Schwannomas, not uncommon in the head and neck, rarely occur in the pelvis. Here we describe a seminal vesicle schwannoma, the first of its kind successfully excised via robotic surgery. An otherwise well 62 year-old male presented with a complaint of rectal pain. Colonoscopy identified a mass effect on the rectum, suggesting an external lesion. A computed tomography scan revealed a right seminal vesicle mass. Transrectal ultrasound guided biopsy returned a tissue diagnosis of schwannoma. To aid in operative planning, magnetic resonance imaging of the prostate and pelvis was obtained with and without contrast. This defined a 5 × 4 × 4 cm mass abutting the right seminal vesicle without evidence of invasion into adjacent structures. The patient underwent an elective robotic-assisted laparoscopic resection of the mass. Final pathology demonstrated a completely excised schwannoma arising from the soft tissue adherent to the right seminal vesicle.
神经鞘瘤在头颈部并不少见,但很少发生于盆腔。在此,我们描述一例精囊神经鞘瘤,这是首例通过机器人手术成功切除的此类肿瘤。一名62岁的男性,身体其他方面健康,因直肠疼痛前来就诊。结肠镜检查发现直肠有占位效应,提示为外部病变。计算机断层扫描显示右侧精囊有肿块。经直肠超声引导下活检的组织诊断为神经鞘瘤。为辅助手术规划,对前列腺和盆腔进行了磁共振成像检查,包括平扫及增强扫描。结果显示一个5×4×4厘米的肿块,紧邻右侧精囊,无侵犯相邻结构的证据。患者接受了择期机器人辅助腹腔镜下肿块切除术。最终病理显示为一个完全切除的神经鞘瘤,起源于附着于右侧精囊的软组织。