Cystadenoma in a seminal vesicle is cured by laparoscopic ablation.

Dear Editor, We present here a case report of a benign seminal vesicle cystadenoma treated with laparoscopic ablation in a 31-year-old man. The clinical presentation, gross appearance, microscopic characteristics, immunohistochemical and ultrastructural findings of this uncommon tumour are discussed. Primary seminal vesicle tumours are rare and may be benign or malignant. Benign primary seminal vesicle tumours include cystadenomas, hydatid cysts, papillary adenomas and amyloid depositions. Malignant primary seminal vesicle tumours include cystosarcoma phyllodes, adenocarcinoma, sarcoma, carcinoid and primary seminoma. In some cases, cystadenoma of the seminal vesicle was an incidental finding of an asymptomatic mass. The majority of patients present with symptoms of urinary outflow obstruction, haematuria or haematospermia. The wide variety of presenting features might result from variations in the size and location of the retrovesical mass. In our case, the presenting symptom was haematospermia, and the retrovesical mass was detected with abdominal pelvic CT. All tumours of the seminal vesicle are resected using open surgery or laparoscopic ablation. Open surgery includes transperineal, transvesical, paravesical, retrovesical and transcoccygeal approaches. In one case, radical cystoprostatectomy, low anterior resection of the rectum and orthotopic neobladder reconstruction were performed. The surgical removal of seminal vesicle tumours via open surgery has become much more difficult. A transvesical approach is believed to be the best surgical approach because it enables full exposure and complete excision of the tumour with minimal risk of damage to the rectum and the bladder nerves. The laparoscopic approach to the management of seminal vesicle cysts has been described. Laparoscopic excision of seminal vesicle disease is an effective surgical procedure associated with minimal postoperative morbidity, short hospitalisation times and rapid recovery for the patient. Macroscopically, the cystadenoma of the seminal vesicle consists of a multilobulated mass containing bloody fluid. A prominent feature of cystadenomas of the seminal vesicle in microscopic examination is that the cystic area is lined with a single layer of columnar or cuboidal epithelium surrounded by a fibrous stroma. Histologically, multiple glands and cysts of varying sizes and shapes are filled with homogeneous eosinophilic material, with no malignant features. The stromal component is abundant. All findings are consistent with cystic epithelial stromal tumour. Immunohistochemical staining is helpful for diagnosing cystadenoma of the seminal vesicle. The epithelium is positive for cytokeratin and negative for calretinin and prostate-specific antigen. The stromal cells show no reactivity for the S-100 protein, but irregular weak positive reactions for smooth muscle actin. We report a 31-year-old man who presented with recurrent haematospermia. An MRI of the pelvis revealed a mass that consisted of both cystic (maximal diameter of 8.8 cm) and solid elements (4.4 cm) (Figure 1). The solid and cystic mass in the left seminal vesicle was