Seminal vesicle metastasis after partial hepatectomy for hepatocellular carcinoma.

Metastasis to the seminal vesicle is extremely rare for hepatocellular carcinoma (HCC). To our knowledge, it has been not reported in literature. The purpose of the present paper was to report a case of metastasis to the seminal vesicle after HCC resection, along with its histological features and immunohistochemical characteristics. A 46-year-old Chinese man was admitted to our hospital due to abdominal distension. He had a history of HCC related to hepatitis B virus infection. Moreover, left partial hepatectomy was performed in another hospital 28 months ago, and right partial hepatectomy for HCC recurrence in our hospital 4 months ago. After resection, radiofrequency ablation therapy had been performed. About 27 months after the initial operation, contrast-enhanced computed tomography (CT) of the pelvic cavity revealed a mass with homogeneous enhancement in the seminal vesicle. Transrectal needle biopsy revealed a poorly differentiated adenocarcinoma. Therefore, seminal vesiculectomy was resected. The histological diagnosis of the removed tumor was compatible with the original HCC. Immunohistochemical examination demonstrated that the tumor cells were positive for glypican-3 (GPC3), alpha-fetoprotein (AFP), hepatocyte paraffin-1 (Hep Par 1), cytokeratin 18 (CK 18), and hepatocyte antigen, which confirmed that the seminal vesicle tumor was a metastatic tumor of HCC. However, CT subsequently revealed multiple metastatic foci in the abdominal and pelvic cavities in May 2009 and August 2009, respectively. The seminal vesicle is an extremely rare metastatic site for HCC, and the prognosis is very poor. A combination of clinical and pathological features is necessary for a correct diagnosis, and primary tumor should be excluded before diagnosing metastatic foci.

肝细胞癌（HCC）转移至精囊极为罕见。据我们所知，文献中尚未有相关报道。本文旨在报道一例肝细胞癌切除术后转移至精囊的病例，并阐述其组织学特征和免疫组化特点。 一名46岁的中国男性因腹胀入院。他有乙肝病毒感染相关的肝细胞癌病史。此外，28个月前在另一家医院进行了左半肝切除术，4个月前在我院因肝癌复发进行了右半肝切除术。切除术后还进行了射频消融治疗。初次手术后约27个月，盆腔增强计算机断层扫描（CT）显示精囊内有一均匀强化的肿块。经直肠针吸活检显示为低分化腺癌。因此，进行了精囊切除术。切除肿瘤的组织学诊断与原发肝细胞癌相符。免疫组化检查显示肿瘤细胞磷脂酰肌醇蛋白聚糖 - 3（GPC3）、甲胎蛋白（AFP）、肝细胞石蜡 - 1（Hep Par 1）、细胞角蛋白18（CK 18）和肝细胞抗原呈阳性，证实精囊肿瘤是肝细胞癌的转移瘤。然而，CT随后分别在2009年5月和2009年8月显示腹腔和盆腔内有多处转移灶。 精囊是肝细胞癌极为罕见的转移部位，预后极差。正确诊断需要结合临床和病理特征，在诊断转移灶之前应排除原发肿瘤。