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Case Reports
. 2016 Dec 1;2(1):227-231.
doi: 10.1089/cren.2016.0119. eCollection 2016.

Paraganglioma of the Seminal Vesicle Case Report and Review of the Literature

Georgi Tosev  1 , Michael Mendler  2 , Frank Bergmann  3 , Tilman Klein  1 , Sascha A Pahernik  1 , Boris A Hadaschik  1 , Markus Hohenfellner  1
Affiliations
Case Reports

Paraganglioma of the Seminal Vesicle Case Report and Review of the Literature

Georgi Tosev et al. J Endourol Case Rep. .

Abstract

Background: The present case report describes an extremely rare case of a norepinephrine secreting extraadrenal paraganglioma (PGL) located in the seminal vesicle. Case Presentation: A 36-year-old patient had signs of intermittent hypertensive derailments, bradycardia, increased norepinephrine excretion in 24-hour urine, an increased metanephrine plasma concentration, and a positive clonidine suppression test. A suspicious mass was detected in an (18)F-DOPA-PET/CT-scan in the left seminal vesicle. Following adrenergic blockade, a robotically assisted laparoscopic left vesiculectomy with negative soft tissue surgical margins was performed. The patient sustained a couple of few months of voiding difficulties of the lower urinary tract and obstruction of the left upper urinary tract after the surgery, which resolved spontaneously with home medical treatment. Two years after the initial treatment, the patient relapsed, which was confirmed by endocrinologic follow-up tests with increased urine catecholamine, a positive clonidine suppression test, as well as an elevated blood pressure. Staging with (18)F-DOPA-PET/CT-scan confirmed the diagnosis of a recurrent PGL. This was followed by subsequent open surgical removal of the suspicious lesion in the seminal fossa. The patient is still recurrence free 15 months after the second surgery. Complications after the second surgery included an intermittent paresthesia of the left leg lasting 3 to 4 months. No other urologic symptoms such as voiding or erectile dysfunction occurred. Conclusion: DaVinci-assisted laparoscopic vesiculectomy is a viable procedure to treat such cases providing satisfactory results. Relevant for clinical practice are the regular and lifelong follow-up examinations to detect recurrences.

Keywords: DaVinci robot; ectopic paraganglioma; seminal vesicle.

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Conflict of interest statement

Statement No competing financial interests exist.

Figures

<b>FIG. 1.</b>
FIG. 1.
(A) Sagittal plane (18)F-DOPA-PET/CT of norepinephrin-producing tumor localized in the left seminal vesicle. (B) Transversal plane (18)F-DOPA-PET/CT of norepinephrin-producing tumor localized in the left seminal vesicle.
<b>FIG. 2.</b>
FIG. 2.
(A) Histological aspect of tumor with confluent nests of polygonal tumor cells. (B) Immunohistochemical positivity for synaptophysin. (C) S100-protein staining revealing few sustentacular cells. (D) KI-67 staining with low proliferation activity.
<b>FIG. 3.</b>
FIG. 3.
Transversal plane (18)F-DOPA-PET/CT of norepinephrine-producing tumor recurrence localized in the left seminal vesicle.
See this image and copyright information in PMC

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