Konta Shuto, Kobayashi Ko, Hashimoto Kohei, Tanaka Toshiaki, Hasegawa Tadashi, Masumori Naoya
Department of Urology, Sapporo Medical University School of Medicine.
Department of Surgical Pathology, Sapporo Medical University School of Medicine.
Nihon Hinyokika Gakkai Zasshi. 2024;115(2):99-103. doi: 10.5980/jpnjurol.115.99.
A 70-year-old man was referred to our institution because of a left seminal vesicle tumor revealed by computed tomography (CT) for postoperative follow-up of malignant melanoma. The prostate-specific antigen level (1.03 ng/mL) was not elevated. We performed transrectal ultrasound-guided seminal biopsy, and the pathological diagnosis was schwannoma. We decided to do follow-up because it was a benign tumor. However, the maximum diameter of the tumor increased over time from 21 mm to 47 mm during 7 years of follow-up. Since malignant potential could not be denied by image diagnosis, we decided to resect the tumor radically. The patient received robot-assisted laparoscopic left seminal vesicle resection. The pathological diagnosis was schwannoma with no malignant features. In such cases, robot-assisted surgery has great advantages in terms of expansion of the operative field and understanding of the three-dimensional structure.
一名70岁男性因计算机断层扫描（CT）发现左侧精囊肿瘤而被转诊至我院，该CT检查是用于恶性黑色素瘤术后随访。前列腺特异性抗原水平（1.03 ng/mL）未升高。我们进行了经直肠超声引导下的精囊活检，病理诊断为神经鞘瘤。由于是良性肿瘤，我们决定进行随访。然而，在7年的随访期间，肿瘤的最大直径随时间从21毫米增加到了47毫米。由于影像学诊断不能排除恶性可能，我们决定行肿瘤根治性切除。患者接受了机器人辅助腹腔镜下左侧精囊切除术。病理诊断为无恶性特征的神经鞘瘤。在此类病例中，机器人辅助手术在扩大手术视野和理解三维结构方面具有很大优势。
