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Review
. 2012;130(1):57-60.
doi: 10.1590/s1516-31802012000100010.

Paraganglioma of seminal vesicle and chromophobe renal cell carcinoma: a case report and literature review

César Augusto Alvarenga  1 , José Manuel Lopes, João Vinagre, Paula Itagyba Paravidino, Marcelo Alvarenga, Adilson Prando, Lísias Nogueira Castilho, Paula Soares, Athanase Billis
Affiliations
Review

Paraganglioma of seminal vesicle and chromophobe renal cell carcinoma: a case report and literature review

César Augusto Alvarenga et al. Sao Paulo Med J. 2012.

Abstract
in English, Portuguese

Context: Extra-adrenal paragangliomas are rare tumors that have been reported in many locations, including the kidney, urethra, urinary bladder, prostate, spermatic cord, gallbladder, uterus and vagina.

Case report: This report describes, for the first time to the best of our knowledge, a primary paraganglioma of the seminal vesicle occurring in a 61-year-old male. The patient presented persistent arterial hypertension and a previous diagnosis of chromophobe renal cell carcinoma. It was hypothesized that the seminal vesicle tumor could be a metastasis from the chromophobe renal cell carcinoma. Immunohistochemical characterization revealed expression of synaptophysin and chromogranin in tumor cell nests and peripheral S100 protein expression in sustentacular cells. Succinate dehydrogenase A and B-related (SDHA and SDHB) expression was present in both tumors.

Conclusions: No genetic alterations to the VHL and SDHB genes were detected in either the tumor tissue or tissues adjacent to the tumor, which led us to rule out a hereditary syndrome that could explain the association between paraganglioma and chromophobe renal cell carcinoma in a patient with arterial hypertension.

CONTEXTO:: Paragangliomas extra-adrenais são tumores raros que têm sido relatados em muitas localizações, incluindo rim, uretra, bexiga, próstata, cordão espermático, vesícula biliar, útero e vagina.

RELATO DE CASO:: Este relato descreve, pela primeira vez em nosso conhecimento, um paraganglioma primário da vesícula seminal ocorrendo em um paciente do sexo masculino de 61 anos de idade. O paciente apresentou hipertensão arterial persistente e um diagnóstico prévio de carcinoma de células renais cromófobo (CCRC). Foi pensado que o tumor de vesícula seminal poderia ser uma metástase do CCRC. A caracterização imunoistoquímica revelou expressão de sinaptofisina e cromogranina nos ninhos de células tumorais e expressão de proteína S100 nas células sustentaculares. Expressão de succinato de-hidrogenase A e B relacionada (SDHA e SDHB) estiveram presentes em ambos os tumores.

CONCLUSÕES:: Nenhuma alteração genética dos genes VHL e SDHB foi detectada nos tecidos tumorais e adjacentes ao tumor, o que nos levou a afastar uma síndrome hereditária que poderia explicar a associação entre o paraganglioma e o CCRC em um paciente com hipertensão arterial.

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Conflict of interest statement

Conflict of interest: None

Figures

Figure 1.
Figure 1.. Paraganglioma of seminal vesicle seen on endorectal magnetic resonance imaging. A) T1-weighted axial image showing a slightly hyperintense solid mass in the left seminal vesicle (arrows).The presence of focal hyperintense areas within the mass is due to the hemorrhagic component of the lesion; B) T2-weighted axial image demonstrating that the mass (arrows) is predominantly hypointense. Note the normal appearance of the right seminal vesicle (*); C) Contrast enhanced, T1-weighted axial image showing that the lesion (arrows) presents a high degree of contrast enhancement. D) Macroscopic appearance: seminal vesicle with a brownish, well-circumscribed smooth nodule measuring 30 mm.
Figure 2.
Figure 2.. Paraganglioma of seminal vesicle: low-power (A); high-power (B); negative expression of CK7 (C); diffuse positive expression of chromogranin (D); positive expression of S100 in sustentacular cells (E); and positive expression of SDHA (F) and SDHB (G).
See this image and copyright information in PMC

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