Man in his late thirties with pelvic mass   

History and CT images

Our appreciation is extended to Drs. Nada Shaker and Anil Parwani at Ohio State University for contributing this case.


A man in his late thirties presented to the OSU seeking management for a pelvic mass involving the seminal vesicles and prostate due to a three-year duration of intermittent, painless, gross hematuria accompanied by initial episodes of hematospermia, which prompted a CT urogram investigation. The CT indicated a 7.2 cm lobulated ill-defined mass arising from the seminal vesicles.

The persistent mass was identified on CT pelvis following a two-week treatment regimen of levofloxacin and prednisone. The patient ultimately underwent a robotic cystoprostatectomy after progressively severe hematuria and urinary incontinence. On gross examination, the specimen revealed a 9.2 × 7.1 × 7.5 cm diffusely cystic, diffusely necrotic mass appearing to arise from the right half of the prostate. Click images to enlarge.