Seminal Vesicle Sampling in Radical Prostatectomy Specimens
H Samaratunga, J Perry-Keene, D Samaratunga, M Adamson, J Yaxley, B Delahunt. Aquesta Pathology, Brisbane, Queensland, Australia; Royal Brisbane Hospital, Brisbane, Queensland, Australia; Wellington School of Medicine and Health Sciences, University of Otago, Wellington, Otago, New Zealand
Background: Seminal vesicle (SV) invasion by prostatic adenocarcinoma is a poor prognostic indicator. There are no guidelines on SV sampling in radical prostatectomy specimens.
Design: Seminal vesicles of 498 consecutive radical prostatectomy specimens were serially sectioned and blocked entirely, grouped as proximal, mid and distal one-third blocks. Carcinomatous infiltration of the muscular wall of each of these and ejaculatory duct/ intraprostatic SV were recorded.
Results: Extraprostatic SV involvement was present in 37 (7.42%) cases (pT3b). The mean age and serum PSA of these patients were 64.1 years (range 52-71) and 10.1 ng /ml (range 3.7- 29) respectively. Eight patients had a palpable nodule or induration on digital rectal examination. Extraprostatic extension and intraprostatic SV/ ejaculatory duct involvement were respectively present in all 37 (100%) and 35 (97%) of these cases. All cases with intraprostatic SV/ejaculatory duct involvement had extraprostatic SV involvement. The mean tumor volume was 5.79 cc (range 1.0-12.1 cc). The tumours had a Gleason score of 4+3 in 4, 4+3 with tertiary pattern 5 in 7, 8 in 2 and 5+4/ 4+5 in 24 cases. All SV positive cases had involvement of the proximal one third (8 right SV, 11 left SV and 18 both SV) 25 of which (67 %) had only proximal SV involvement. For the remainder, 6 had mid one third and 6 had mid and distal one third involvement in addition to proximal SV involvement.
Conclusions: In this study, mid or distal SV carcinomatous involvement was not found in the absence of proximal seminal vesicle involvement. Blocking the proximal part of the seminal vesicles should be sufficient to identify all cases of carcinomatous involvement of SV. In cases with intraprostatic SV/ ejaculatory duct involvement, thorough examination of the extraprostatic SV is warranted if the initial examination does not demonstrate carcinoma.
Category: Genitourinary (including renal tumors)
Monday, March 22, 2010 1:00 PM
Poster Session II # 115, Monday Afternoon