Department of Urology, Hospital Aleman, Buenos Aires, Argentina.
Urologia. 2023 Aug;90(3):594-597. doi: 10.1177/03915603211028450. Epub 2021 Jul 25.
Primary leiomyosarcoma of the seminal vesicle is an extremely rare and highly malignant disease with less than 15 cases reported.
A 34-year-old man presented with acute urinary symptoms. Imagen studies showed an abdominal mass (80 mm × 65 mm × 50 mm) with contrast enhancement, compressing the right side of the bladder but with a clear cleavage level between surrounding organs. The patient underwent a transrectal US-guided biopsy which was informed as compatible with leiomyosarcoma by immunohistochemical characterization. We performed a cystoprostatectomy and pelvic lymphadenectomy plus radiotherapy. Pathology showed a 7.5 cm × 6 cm nodular para-vesical Leiomyosarcoma histological grade 2 with 0/22 lymph nodes involved. Twelve months after the surgery no recurrences have presented.
A multi-disciplinary therapeutic approach, combined with close follow-up, is mandatory to obtain good outcomes in such rare and challenging cases.
原发性精囊平滑肌肉瘤是一种极其罕见且高度恶性的疾病，报道病例不足 15 例。
一名 34 岁男性出现急性尿路症状。影像学研究显示腹部有一个肿块（80mm×65mm×50mm），增强扫描可见，肿块压迫右侧膀胱，但与周围器官之间有明确的分离平面。患者接受了经直肠超声引导下的活检，免疫组化特征提示符合平滑肌肉瘤。我们进行了膀胱前列腺切除术和盆腔淋巴结清扫术加放疗。病理显示 7.5cm×6cm 结节性副精囊平滑肌肉瘤，组织学分级 2 级，22 个淋巴结无受累。术后 12 个月未出现复发。
对于如此罕见和具有挑战性的病例，需要多学科的治疗方法，并结合密切随访，以获得良好的结果。
