Abstract
RATIONALE: Primary seminal vesicle adenocarcinoma is a rare type of male reproductive system tumor, primarily manifesting as papillary adenocarcinoma. Meanwhile, clear cell adenocarcinoma (CCA) is a common malignancy in the female reproductive system. Therefore, the occurrence of CCA in the seminal vesicle, showing ovarian homology, is even rarer. This pathological type of seminal vesicle cancer has been seldom reported. PATIENT CONCERNS: A 43-year-old male patient presented to the outpatient clinic with a decade-long history of intermittent hemospermia accompanied by a 2-month sensation of dragging in the left lower abdomen. Following an MRI scan that indicated a seminal vesicle mass, he was admitted for further treatment. DIAGNOSIS: The MRI revealed 2 abnormal signal mass lesions located between the left side of the pelvic cavity, the prostate, and the left seminal vesicle, primarily exhibiting long T1 and long T2 cystic characteristics. The CT scan with enhancement showed mixed density mass shadows in the left seminal vesicle area of the pelvic cavity, with mild arterial phase enhancement and continued enhancement in the portal phase. Physical examination revealed mild tenderness in the lower left abdomen. Digital rectal examination detected a hard mass above the left prostate, with no bloodstain on the glove, and no other significant abnormalities were observed. Routine urinalysis and biochemistry did not reveal any notable abnormalities. Tumor markers were all within normal ranges. INTERVENTIONS: The tumor was completely excised laparoscopically and sent for pathological examination. Nine days postoperatively, the patient was successfully discharged. OUTCOMES: Postoperative pathology indicated primary CCA of the seminal vesicle. During a 20-month follow-up via telephone, the patient reported a generally good condition without significant discomfort. LESSONS: CCA occurring in the seminal vesicle is extremely rare, and radical surgical excision is the primary treatment method.