Squamous Cell Carcinoma of the Seminal Vesicle from Zinner Syndrome: A Case Report and Review of Literature

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/ by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Until now, fewer than 60 cases of tumors originating from the seminal vesicle have been reported. Most of them were ade-nocarcinoma, cystadenoma, and benign mesenchymal tumor. 1 Among them, only three cases in the English literature have been reported as squamous cell carcinoma. Although all three cases had a prolonged history of stone formation or chronic inflammation , none of them were associated with congenital mal-formation of the urogenital system such as Zinner syndrome. Zinner syndrome is a rare Müllerian duct abnormality consisting of unilateral renal agenesis, ipsilateral seminal vesicle cyst, and ejaculatory duct obstruction. Herein, we report a 41-year-old male with Zinner syndrome, who developed a poorly differentiated squamous cell carcinoma of the seminal vesicle as a result of prolonged inflammation. A 41-year-old male was admitted to our hospital due to gross hematuria for two and a half months. Twelve years previous, the patient underwent transurethral resection, suprapubic cystosto-my, and urethral sounds to cure a right seminal vesicle cyst with multiple stones and obstruction of the right ejaculatory duct. At that time, a biopsy diagnosed the seminal vesicle cyst as an epidermal cyst, a benign cyst lined with a thin layer of squa-mous epithelium. A week after his current admission, perineal and scrotal pains newly developed. Digital rectal examination detected tenderness with a hard and highly elevated posterior prostate compressing the rectal wall. No prostate-specific anti-gen elevation was detected and urine cytology was negative for malignant cells. Computed tomography (CT) urography revealed hypoplastic change in the right kidney, a 4.9-cm-sized right seminal vesicle cyst with a thickened wall, and benign prostate hyperplasia (Fig. 1A). The patient was diagnosed with Zinner syndrome with a seminal vesicle cyst. Transrectal sonog-raphy detected a 3.8-cm-sized hypoechoic lesion at the left transitional zone of the prostate showing a bulging contour and prominent vascularity, which favored chronic prostatitis over ma-lignancy. Treatment included not only palliative medication but also aggressive procedures such as nerve blocking for pain control. Six months after the initial onset of gross hematuria, another transrectal biopsy was done and the specimen was pathologically diagnosed as poorly differentiated carcinoma. CT urog-raphy and magnetic resonance imaging demonstrated a bulging mass at the left prostate gland, which had …