Seminal vesicle metastasis after liver transplantation for hepatocellular carcinoma

Abstract

Rationale:Cancer recurrence and metastasis after liver transplantation (LT) is common in some hepatocellular carcinoma (HCC) patients. The most common sites of extrahepatic metastases are lung, regional lymph node, adrenal gland, and bone. To our knowledge, HCC metastasis to the seminal vesicle after LT has not been reported in the literature.Patient concerns:A 56-year-old Asian man presented at hospital with a 9-year history of orthotopic LT because of HCC. The patient underwent surgery and radiotherapy for HCC metastasis to adrenal gland and 1 year later, chemotherapy for peritoneal metastasis. A few months later, the patient presented with computed tomography (CT) image showing masses in right lobe of liver, seminal vesicle, and space occupying mass between the spleen and stomach.Diagnoses:Combination of clinical and pathological features revealed the seminal vesicle mass as metastasis from HCC.Interventions:Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for liver and seminal vesicle lesions was performed and the postoperative pathology revealed malignancy. Thus, the patient underwent surgery and the diagnosis of seminal vesicle metastasis of HCC was confirmed by pathology and immunohistochemical analysis.Outcomes:The patient died due to systemic failure.Lessons:Seminal vesicle metastasis from HCC after LT is rare and there is no consensus on its treatment. Further research into the pathogenesis and therapy of seminal vesicle from HCC after LT is needed to improve outcomes in the rare disease.

Seminal vesicle mass: An unusual site for metastatic hepatocellular carcinoma after orthotopic liver transplant

“…HCC metastasis to the seminal vesicles after liver transplant is very rare, with only one other case reported in a patient with already documented metastases. 2 In this case, the patient had a history of HCC status post orthotopic liver transplant. His preoperative imaging did not reveal any abnormalities in the prostate, bladder, or rectum; his rectal exam was within normal limits, and a recent colonoscopy was normal.…”

“…Thus far in the literature, there are only two reported cases that describe metastasis of hepatocellular carcinoma (HCC) to the seminal vesicle. 1 , 2 Given that the most common sites of extrahepatic metastases occur in the lung, adrenals, bone, or lymph nodes, the fact that the seminal vesicle is the site of initial metastasis for a primary liver cancer is unheard of. 3 Herein we present the first documented case of a seminal vesicle as the initial site of metastasis in a patient with a history of liver transplantation for HCC.…”

Gene Expression Characteristics of Liver Tissue Reveal the Underlying Pathogenesis of Hepatocellular Carcinoma

“…Liver transplantation is the preferred treatment [ 5 , 6 ]. The most common sites of extrahepatic metastases include the lung, regional lymph nodes, adrenal glands, and bone [ 7 ]. The limited treatment options for patients with advanced HCC have become a significant problem [ 8 ].…”