Laparoscopic surgery combined with the double-J tube implantation for the rare cystic-solid schwannoma of seminal vesicle: A Case Report and Literature Review

Abstract

Rationale: Schwannoma is common in young and middle-aged people and occurs in the head, neck, posterior mediastinum, and retroperitoneal. Schwannoma, on the other hand, is a rare occurrence in the seminal vesicle. Early diagnosis and treatment are crucial since the disease can cause lower abdominal pain, nocturia, frequent urination, blood sperm, and other symptoms. There is no standard diagnostic or treatment guideline for seminal vesicle schwannomas currently. Therefore, the treatment experience relies on the few cases reported throughout the world.

Patient concerns: A 45-year-old male patient discovered that the tumor beside the right side spermatophore is bigger than 3 years ago.

Diagnosis: Schwannoma of seminal vesicle.

Interventions: Ureter double-J tube implantation and laparoscopic surgery for schwannoma of seminal vesicle.

Outcomes: The operation process went smoothly. And the patient was no discomfort after half a year.

Conclusion: Schwannoma of the seminal vesicle is very rare in the clinic, and the imaging examination was not conclusive. The diagnosis mainly depends on pathological results. Surgical resection is the best treatment method for schwannoma. In surgery for schwannoma of seminal vesicle, combined with the ureter double-J tube implantation are many benefits. This case is an excellent example of the seminal vesicle schwannomas.

Figure 1.

(A) Color Doppler ultrasound indicated a solid mass with rich blood flow beside the seminal vesicle on the right side of the pelvis. (B) The right side wall of the bladder and the right seminal vesicle gland are slightly pushed. (C) Color Doppler image after 2 months. (D) Color Doppler image after 2 months.

Figure 2.

(A) MRI (T1WI) scan indicated an oval-shaped solid mass next to the seminal vesicle gland, about 5.3 cm × 3.4 cm in size. (B) DWI indicated high signal intensity of the mass. DWI = diffusion-weighted imaging, T1WI = T1 weighted image.

Figure 3.

(A) Cross section (MRI T2WI) suggests that the mass is slightly higher and low confounded signal, and the prostate, the right seminal vesicle gland and the right wall of the bladder are compressed. (B) Cross section with enhancement showed that the tumor was slightly uneven and continued to strengthen and the cyst wall was slightly strengthened. (C) Coronal plane (MRI T2WI). (D) Coronal plane with enhancement. (E) Sagittal plane (MRI T2WI). (F) Sagittal plane with enhancement.

Figure 4.

(A) KUB scan (October 28, 2018) indicated that the double-J tube is in good position after the operation. (B) KUB scan (December 8, 2018) indicated that the double-J tube is in good position after the operation. KUB = kidney ureter bladder.

Figure 5.

Pathological examination demonstrated that the mass is composed of a loose cell area and a dense area. Among them, the cell morphology is mild, and some are arranged in a fence shape (hematoxylin and eosin staining; magnification, ×200). Immunohistochemistry showed: S-100(+), Ki-67(+<1%).