OncoTargets and Therapy (Jul 2016)
Congenital anomalies of the genitourinary system can help in diagnosis of the primary site of metastatic cancer: a case report and a review of the literature
Abstract
Andrzej Deptala,1,2 Agnieszka Romanowicz,2 Aleksandra Czerw,3 Jerzy Walecki,4 Wojciech Rogowski,5 Anna Nasierowska-Guttmejer6 1Department of Oncology and Hematology, Central Clinical Hospital of the Ministry of Interior, 2Department of Cancer Prevention, 3Department of Public Health, Faculty of Health Sciences, Medical University of Warsaw, 4Department of Radiology, Postgraduate Medical School, 5Department of Urology, 6Department of Pathology, Central Clinical Hospital of the Ministry of Interior, Warsaw, Poland Objective: To analyze whether the presence of congenital anomalies of the genitourinary system that are accompanied by specific types of cancer and predispose patients to many complications, including infection, obstruction, stasis, calculus formation, and impaired renal function, could help in the diagnosis of the primary site of a metastatic tumor.Case presentation: We report a case of a 58-year-old man with metastatic adenocarcinoma, in whom congenital anomalies of the genitourinary system proved helpful for the diagnosis of the primary site of cancer originating in the seminal vesicles.Conclusion: We report an extremely rare case of primary adenocarcinoma arising probably from the left seminal vesicle associated with ipsilateral renal agenesis. The lesion was detected on ultrasound and contrast-enhanced computed tomography and confirmed histologically with ultrasound-guided biopsy. Serum markers, ie, CA19-9 and CA125, were elevated, while prostate-specific antigen and carcinoembryonic antigen were within normal limits. Such a constellation of markers strengthened the diagnosis. Our patient unfortunately presented very late in the course of the disease. Hence, we decided to initiate antiandrogen therapy and best supportive care in a hospice setting. Only early detection seems to be the key factor that may result in improved cure rates for cancer of the seminal vesicles. We also performed a literature search for current concepts related to the diagnosis and clinical management of primary adenocarcinoma of seminal vesicles. Keywords: congenital anomalies of the genitourinary system, seminal vesicles carcinoma, case report, diagnosis, treatment