Peritoneal metastases invading the seminal vesicles: Radiologic appearance and outcome of treatment

Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) may be of greatest benefit if all visible evidence of disease is resected. In some male patients the peritoneal metastases within the pelvis are invasive into the seminal vesicles and complete cytoreduction requires resection of these structures.

From a prospective database of colorectal and appendiceal cancer patients who had CT evidence of seminal vesicle involvement and then had cytoreduction including resection of the seminal vesicles were reviewed. Their clinical features were tabulated.

Five patients were identified between ages 52 and 60. Three of 5 were appendiceal mucinous neoplasms and 4 of 5 had complete cytoreduction. Two of the patients are long-term survivors of 120 and 28 months. All patients are impotent and reported no return of sexual function over time. All five patients report normal micturition.

Resection of the seminal vesicles in a patient with invasion of these structures by peritoneal metastases is possible and should be considered in selected patients. This resection causes impotence but normal urination is to be expected.