Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 16, 2021; 9(23): 6775-6780
Published online Aug 16, 2021. doi: 10.12998/wjcc.v9.i23.6775
Solitary seminal vesicle metastasis from ileal adenocarcinoma presenting with hematospermia: A case report
Xiao-Bao Cheng, Zhen-Quan Lu, Wayne Lam, Ming-Kwong Yiu, Ji-Shi Li
Xiao-Bao Cheng, Zhen-Quan Lu, Wayne Lam, Ming-Kwong Yiu, Department of Surgery, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518053, Guangdong Province, China
Wayne Lam, Ming-Kwong Yiu, Division of Urology, Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
Ji-Shi Li, Department of Oncology, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518053, Guangdong Province, China
Author contributions: Cheng XB, Lu ZQ and Li JS collected the clinical data; Cheng XB searched the literature and wrote the manuscript; Wayne Lam and Yiu MK reviewed and edited the manuscript; all authors have read and approved the final manuscript.
Informed consent statement: Written informed consent for the publication of this case and any accompanying images were obtained from the patient.
Conflict-of-interest statement: The authors declare that there is no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016) statement, and the manuscript was prepared and revised according to the CARE Checklist (2016) statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Bao Cheng, MD, Chief Doctor, Surgeon, Surgical Oncologist, Department of Surgery, The University of Hong Kong-Shenzhen Hospital, No. 1 Haiyuan 1st Road, Futian District, Shenzhen 518053, Guangdong Province, China. chengxb@hku-szh.org
Received: March 5, 2021
Peer-review started: March 5, 2021
First decision: April 29, 2021
Revised: May 9, 2021
Accepted: May 19, 2021
Article in press: May 19, 2021
Published online: August 16, 2021
Processing time: 153 Days and 5.6 Hours
Abstract
BACKGROUND

Although metastatic adenocarcinoma of the ileum is not uncommon, solitary metastasis to the seminal vesicle has not been reported. We report a patient with recurrent hematospermia diagnosed with metastasis to the seminal vesicle following ileal adenocarcinoma resection, his subsequent management and outcome.

CASE SUMMARY

A 46-year-old man presented with recurrent episodes of painless hematospermia. This was not associated with any lower urinary tract symptoms. He had a past medical history of ileal tumor at the terminal ileum with solitary mesenteric lymph node metastasis on presentation, and underwent partial ileectomy and lymphadenectomy 4 years ago. Subsequent investigations included positron-emission tomography and computed tomography imaging confirmed the very unusual diagnosis of a solitary tumor at the left seminal vesicle. Laparoscopic left-sided vesiculectomy was carried out. Histological analysis with immunohistochemistry showed that CDX-2 was positive and CK7 was negative, and the appearance was consistent with the diagnosis of recurrent metastatic adenocarcinoma of his previously treated intestine primary. The patient had an uneventful post-operative recovery. He received adjuvant chemoradiotherapy following surgery. He remained asymptomatic until he developed multiple bone and pulmonary metastases one year after surgery.

CONCLUSION

Clinicians should be aware of hematospermia as the first symptom of metastatic recurrence in patients with a history of ileal adenocarcinoma.

Keywords: Seminal vesicle; Metastasis; Ileal adenocarcinoma; Hematospermia; Laparoscopic vesiculectomy; Case report

Core Tip: A 46-year-old man with a history of a partial ileectomy and adjuvant chemotherapy for ileal adenocarcinoma 4 years prior to presentation at our clinic with hematospermia. Subsequent investigations confirmed the very unusual diagnosis of a solitary tumor at the left seminal vesicle. Laparoscopic left-sided vesiculectomy was carried out. Histological analysis with immunohistochemistry showed that CDX-2 was positive and CK7 was negative, and the appearance was consistent with the diagnosis of recurrent metastatic adenocarcinoma of his previously treated intestine primary. He received adjuvant chemoradiotherapy following surgery. He remained asymptomatic until he developed multiple bone and pulmonary metastasis one year after surgery.