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...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 positronemission tomography and computed tomography imaging confirmed the very unusual diagnosis of a solitary tumor at the left seminal vesicle.Laparoscopic leftsided 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.展开更多
This study aimed to describe endoscopic anatomy of the seminal tract and summarize our experience of transutricular seminal vesiculoscopy(TSV)guided by rea卜time transrectal ultrasonography(TRUS)in managing persistent...This study aimed to describe endoscopic anatomy of the seminal tract and summarize our experience of transutricular seminal vesiculoscopy(TSV)guided by rea卜time transrectal ultrasonography(TRUS)in managing persistent hematospermia.A total of 281 consecutive patients with persistent hematospermia who underwent TSV with or without real-time TRUS were enrolled in this single-center,prospective,observational study.The median follow-up period was 36.5(range:8.0-97.5)months.TSV was successfully performed in 272(96.8%)patients.The approach of a 4.5/6 F rigid vesiculoscope entering the seminal tract was categorized into four types on the basis of endoscopic presentation of the ejaculatory duct orifice and verumontanum.Seven(2.6%),74(27.2%),64(23.5%),and 127(46.7%)patients had Types I(through the ejaculatory duct in the urethra),II(through the ejaculatory duct in the prostatic utricle),III(transutricular fenestration through a thin membrane),and IV(real-time transrectal ultrasound-guided transutricular fenestration)approach,respectively.In patients who successfully underwent surgery,bleeding occurred in the seminal vesicle in 249(91.5%)patients.Seminal vesiculitis,calculus in the prostatic utricle,calculus in the ejaculatory duct,calculus in the seminal vesicle,prostatic utricle cysts,and seminal vesicle cysts were observed in 213(78.3%),96(35.3%),22(8.1%),81(29.8%),25(9.2%),and 11(4.0%)patients,respectively.Hematospermia was alleviated or disappeared in 244(89.7%)patients 12 months after surgery.Fifteen patients had recurrent hematospermia,and the median time to recurrence was 7.5(range:2.0-18.5)months.TSV guided by TRUS may contribute to successful postoperative outcomes in managing persistent hematospermia.展开更多
文摘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 positronemission tomography and computed tomography imaging confirmed the very unusual diagnosis of a solitary tumor at the left seminal vesicle.Laparoscopic leftsided 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.
文摘Objective To treat hematospermia by ureteroscopy and investigate its application value for treatment of hematospermia. Methods Nineteen patients with
基金the National Nature Science Foundation of China(Grant No.81670625)Shandong Province Natural Science Foundation-Doctoral Fund(No.ZR2017BH104)Shandong Province Natural Science Foundation-Surface Project(No.ZR2018MH006).
文摘This study aimed to describe endoscopic anatomy of the seminal tract and summarize our experience of transutricular seminal vesiculoscopy(TSV)guided by rea卜time transrectal ultrasonography(TRUS)in managing persistent hematospermia.A total of 281 consecutive patients with persistent hematospermia who underwent TSV with or without real-time TRUS were enrolled in this single-center,prospective,observational study.The median follow-up period was 36.5(range:8.0-97.5)months.TSV was successfully performed in 272(96.8%)patients.The approach of a 4.5/6 F rigid vesiculoscope entering the seminal tract was categorized into four types on the basis of endoscopic presentation of the ejaculatory duct orifice and verumontanum.Seven(2.6%),74(27.2%),64(23.5%),and 127(46.7%)patients had Types I(through the ejaculatory duct in the urethra),II(through the ejaculatory duct in the prostatic utricle),III(transutricular fenestration through a thin membrane),and IV(real-time transrectal ultrasound-guided transutricular fenestration)approach,respectively.In patients who successfully underwent surgery,bleeding occurred in the seminal vesicle in 249(91.5%)patients.Seminal vesiculitis,calculus in the prostatic utricle,calculus in the ejaculatory duct,calculus in the seminal vesicle,prostatic utricle cysts,and seminal vesicle cysts were observed in 213(78.3%),96(35.3%),22(8.1%),81(29.8%),25(9.2%),and 11(4.0%)patients,respectively.Hematospermia was alleviated or disappeared in 244(89.7%)patients 12 months after surgery.Fifteen patients had recurrent hematospermia,and the median time to recurrence was 7.5(range:2.0-18.5)months.TSV guided by TRUS may contribute to successful postoperative outcomes in managing persistent hematospermia.
