Alparslan SERARSLAN, Nilgun OZBEK OKUMUS, Bilge GÜRSEL, Deniz MEYDAN, Şaban SARIKAYA, Mehmet KEFELİ, Sibel UCAK

Isolated seminal vesicle metastasis from gastric adenocarcinoma: first case report

A 49-year-old Turkish man underwent subtotal gastrectomy for gastric cancer in February 2010. The cancer was staged as pT4aN0M0R0. The patient received adjuvant chemoradiotherapy per the Intergroup study 0116. Regular follow-up abdominopelvic computed tomography revealed a contrast-enhancing right seminal vesicle lesion 35 months after gastric surgery. Staging evaluation using (18) F-fluorodeoxyglucose positron emission tomography/computed tomography revealed isolated seminal vesicle fluorodeoxyglucose uptake. A right seminal vesiculectomy was then performed. Histologic examination of the seminal vesicle specimen revealed that the sample was similar to the original gastric adenocarcinoma. The tumor board recommended external beam radiotherapy due to the close surgical margin, but the patient refused treatment. Five months after right seminal vesiculectomy, tumor recurrence was found. Tumor excision and left seminal vesiculectomy were performed, and 45 Gy external beam radiotherapy was delivered to the region of recurrence in February 2014. As of January 2016, the patient has had no complaints since the last radiation treatment. In conclusion, we report the first case of isolated seminal vesicle metastasis from gastric adenocarcinoma. Therefore, seminal vesicles should be considered a potential recurrence site in primary gastric adenocarcinoma. The combination of surgery and radiation (45 Gy dose) without chemotherapy appeared to be successful in treating this gastric adenocarcinoma metastasis.

Keywords:

Gastric cancer, Male urologic surgery, Metastasis, Radiotherapy, Seminal vesicles,

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András, C., Tóth, L., Pósán J., Csiki, E., Tanyi, M., Csiki, Z., Garami, Z., Enyedi, A., Flaskó, T., Horváth, Z., 2013. Occurrence of bladder metastasis 10 years after surgical removal of a primary gastric cancer: a case report and review of the literature. J. Med. Case Rep. 7, 204.
Egevad, L., Ehrnström, R., Håkansson, U., Grabe, M., 2007. Primary seminal vesicle carcinoma detected at transurethral resection of prostate. Urology. 69, 778.
Ferlay, J., Soerjomataram, I., Dikshit, R., Eser, S., Mathers, C., Rebelo, M., Parkin, D.M., Forman, D., Bray, F., 2015. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int. J. Cancer. 136, bE359-386.
Gong, L., Zheng, M., Li, Y., Zhang, W., Bu, W., Shi, L., Zhang, W., Yan, H., 2011. Seminal vesicle metastasis after partial hepatectomy for hepatocellular carcinoma. BMC Cancer. 11, 111.
Lee, B.H., Seo, J.W., Han, Y.H., Kim, Y.H., Cha, S.J., 2007. Primary mucinous adenocarcinoma of a seminal vesicle cyst associated with ectopic ureter and ipsilateral renal agenesis: a case report. Korean J. Radiol. 8, 258-261.
Macdonald, J.S., Smalley, S.R., Benedetti, J., Hundahl, S.A., Estes, N.C., Stemmermann, G.N., Haller, D.G., Ajani, J.A., Gunderson, L.L., Jessup, J.M., Martenson, J.A., 2001. Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N. Engl. J. Med. 345, 725-730.
Morganti, A.G., Di Castelnuovo, A., Massaccesi, M., Cellini, F., Cilla, S., Macchia, G., Forte, P., Buwenge, M., Digesu, C., Ferro, M., Picardi, V., Caravatta, L., Valentini, V., Deodato, F., 2013. Planning comparison between standard and conformal 3D techniques in post-operative radiotherapy of gastric cancer: a systematic review. Br. J. Radiol. 86, 20130274.