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This case report documents seminal vesicle cystadenoma with concurrent prostate cancer in a 49-yearold man evaluated at follow-up for a high prostate-specific antigen level (12 ng/ml). Transrectal ultrasound-guided prostate biopsy was performed for adenocarcinoma of the prostate (Gleason score 3+4= 7). Staging computed tomography showed a 6.6×5.5×5.0 cm cystic tumorof the seminal vesicle. A possible diagnosis of primary malignant tumor of the seminal vesicle with concurrent organ-confined prostate cancer was considered. However, seminal vesicle tumor biopsy was not performed because the patient underwent open radical prostatectomy with the resection of the seminal vesicle tumor. Histopathologic examination of the seminal vesicle and the prostate revealed cystadenoma (Gleason score 4+3=7) and adenocarcinoma (stage pT2cN0). Neither recurrence of the cystadenoma nor biochemical recurrence of the prostate cancer was observed 5 years and 6 months after the surgery.

A 78-year-old man withurinary retention visited our hospital in June 2011. He presented with intestinal bleeding one monthlater and was admitted immediately. Contrast enhancement computed tomography revealed a lobulated intrapelvic tumor and liver metastasis. The prostate specific antigen level was normal, but his carcinoembryonic antigen level was elevated. Based on these results, his tumor was diagnosed as rectal carcinoma. On day 26, total pelvic exenteration and pelvic lymphnode dissection to arrest bleeding were performed. We created an ileal conduit for urinary diversion and performed a sigmoid colostomy. The final histopathological assessment confirmed that he had primary adenocarcinoma of the seminal vesicle. The patient received the best supportive care because he rejected postoperative adjuvant chemotherapy and hormonal therapy. He died three months postoperatively. Primary adenocarcinoma of the seminal vesicle is very rare. The prognosis for this carcinoma is poor.

30歳男。肛門部痛, 排尿後疼痛, 血尿を主訴に受診し, 急性前立腺炎を疑い入院となった。CTにて右腎無形成と骨盤内に嚢胞性病変を認め左精管からの茶褐色液の流出と造影剤の嚢胞内への流入が見られ左精嚢嚢胞と診断した。内容液の細胞診はclass 1で定期的に精嚢嚢胞穿刺を行い, 内容液を吸引していたが12年後には症状出現期間が極めて短くなり毎月, 穿刺を繰り返すようになり内容液の細胞診はclass IIIで精嚢嚢胞壁の不整が目立つようになった。2ヵ月後にTRUS下精嚢生検と精嚢嚢胞穿刺を行い細胞診classIVで乳頭状腺癌と診断し手術目的で入院となり患者の性機能と膀胱温存希望により精嚢摘出術を施行した。精嚢と膀胱頸部での癒着が強く, 左精嚢摘出後, 周囲組織への浸潤がないことを確認し, 右精嚢も摘除したが嚢胞内面に多発性腫瘍が乳頭状に発育しており組織学的には乳頭状腺癌で一部低分化腺癌がみられ, CA125(+)であった。3ヵ月後膀胱後面に嚢胞状病変が出現し, 精嚢癌の再発と診断し, 腫瘍摘除, 膀胱全摘術, 回腸導管造設術を施行し, 放射線治療を行うも骨盤腔内腫瘍増大と肝転移のために死亡した。, We report a case of papillary adenocarcinoma inside a seminal vesicle cyst associated with contralateral renal agenesis in a 30-year-old man. Coexistence of a seminal vesicle cyst and tumors is rare. Surgical excision was performed but he died due to liver metastases one year later.

Primary amyloidosis of the seminal vesicle is a rare disease entity. We report here a case of localized seminal vesicle amyloidosis with hematospermia. A 66-year-old man visited our hospital with a chief complaint of hematospermia. T2 weighted magnetic resonance imaging (MRI) showed a hypointensity mass in the left seminal vesicle. Needle biopsy revealed amyloidosis of the seminal vesicle. Without any specific treatment, the mass lesion disappeared on MRI, and hematospermia was improved.

1)去勢した幼若ラット精嚢のnuclear ERは臓器当たり, 単位重量当たり, 及び単位蛋白当たりの検討において, 無処置群に比べて含量が増加した.腺管周囲間質領域にER陽性細胞が密に分布し, ERの明確な組織内局在を認めた.RT-PCR法を用いたERmRNA発現の検討でも増強を認めた. 2)去勢ラットにエストロジェンを投与し1週後には精嚢のnuclear ERは臓器当たり, 単位重量当たり, 及び単位蛋白当たりでも, 去勢群に比べて含量が更に増加した.このことは, エストロジェン投与によって腺管上皮細胞, 基底細胞及び周辺部間質領域にER陽性細胞が更に出現してくるという免疫組織学的所見に相関した, We have already reported that estrogen treatment given to immature castrated rats caused proliferative changes in both collagen and smooth muscle in the seminal vesicles of immature rats detected by light microscopy. Herein, we studied the estrogen-induced changes in estrogen receptor (ER) in the seminal vesicles of immature castrated rats by means of enzyme immunoassay, an immunohistochemical method and RT-PCR, to clarify the mechanism of estrogen induced proliferation of collagen and smooth muscle. Immature rats (3 weeks old) were castrated and left untreated for 3 weeks and then injected subcutaneously with estradiol-17 beta (E2-17 beta, 5 micrograms/day) for 7 days before they were killed. The nuclear ER content per gland, mg tissue and mg protein in the seminal vesicles of castrated rats increased markedly compared with those of non-treated rats. Castration also enhanced ERmRNA expression. The immunohistochemical analysis demonstrated the obvious tissue distribution by which the nuclear ER positive cells were densely distributed in the periglandular stroma. The nuclear ER contents per gland, mg tissue and mg protein in the seminal vesicles of estrogen-treated castrated rats were greater than those in castrated rats. Estrogen treatment further enhanced ERmRNA expression in the castrated rats. The immunohistochemical studies demonstrated that the nuclear ER positive cells appeared among the glandular epithelial cells, basal cells and the peripheral stromal cells, in addition to the periglandular stromal cells. These findings suggest that ER is related to the estrogen induced proliferation of collagen and smooth muscle in the seminal vesicles of immature castrated rats.

前立腺および精嚢の腺管と間質がアンドロジェン・エストロジェンに対してどのような反応特性を持っているかについて思春期前去勢ラットを用いて検討した。1)アンドロジェンは思春期前去勢ラットの前立腺および精嚢の腺管上皮の増殖と分化を促すのみならず, 間質コラーゲンの合成と蓄積を促すという諸家らの報告を再確認した。2)エストロジェン2週投与時の前立腺側背葉の腺管上皮細胞層は腹葉や精嚢に比べてより厚く, 2～3層に重層していた。しかし, 細胞の分化の指標であるアンドロジェン依存性蛋白・EMBPの合成促進はなかった。すなわち, エストロジェンは副性器の腺管上皮の増殖を促し, その強さは臓器によって異なっていた。3)エストロジェン2週投与は前立腺および精嚢の間質コラーゲンを増加させた。増加の度合いは前立腺腹葉, We investigated the hormonal responsiveness of gland and stroma in the male accessory sex organs (ventral prostate, dorsolateral prostate and seminal vesicle). Immature rats (3 weeks old) were castrated and left untreated for 4 weeks and then distributed at random into 3 groups, A, B, C. The rats in groups A, B and C were injected subcutaneously with 0.2 ml of soybean oil, 5 alpha-dihydrotestosterone (DHT, 500 micrograms/day) or estradiol-17 beta (E2-17 beta, 5 micrograms/day), respectively, for 14 days before they were killed. DHT administration in prepuberal castrates stimulated collagen synthesis and accumulation in the stroma of male accessory sex organs as well as the proliferation and differentiation of the glandular epithelium in these organs. In E2-17 beta treated rats, the glandular epithelium of ventral prostate and seminal vesicle had mostly a single layer structure, but the glandular epithelium of dorsolateral prostate had a mostly multilayer structure. On the other hand, in E2-17 beta treated rats, the EMBP content, an indicator of glandular epithelium differentiation in male accessory sex organs, did not increase even in the dorsolateral prostate which showed a multilayer gland epithelium. Collagen synthesis and accumulation in the seminal vesicle was stimulated by E2-17 beta treatment several times as much as in the ventral and dorsolateral prostate. Histological investigation demonstrated that the seminal vesicle in prepuberal castrates treated with E2-17 beta resembled that of fibromuscular type human benign prostatic hyperplasia.

A case of right intrascrotal and seminal vesicular granuloma probably induced by Propionibacterium acnes is reported. A 62-year-old man was admitted to our department because of low grade fever and the right intrascrotal and retrovesical masses without tenderness. Ultrasonography computed tomography, magnetic resonance imaging and vesiculography suggested a neoplasm. However, leukocytosis and high erythrocyte sedimentation rate (ESR) and c-reactive protein level (CRP) suggested inflammatory disease. He was treated for 1 week with parenteral cefazolin (CEZ) (4 g/day), and the intrascrotal mass was remarkably reduced in size. To rule out neoplasms, right orchiectomy and needle biopsy of the right seminal vesicle were performed and nonspecific chronic granuloma was identified histologically. On the 5th postoperative day he developed fever (39.2 degrees C) and P. acnes was isolated from blood culture. Gram stain revealed gram-positive rods in the specimen. Further chemotherapy normalized levels of ESR and CRP and white blood cell count and reduced the right seminal vesicle to its normal size. Recently several cases of infection induced by P. acnes have been reported, but this is the first report in the genitourinary tract.