Seminal vesicle schwannoma presenting as rectal pain: successful robotic-assisted excision

Schwannomas, not uncommon in the head and neck, rarely occur in the pelvis. Here we describe a seminal vesicle schwannoma, the first of its kind successfully excised via robotic surgery. An otherwise well 62-year-old male presented with a complaint of rectal pain. Colonoscopy identified a mass effect on the rectum, suggesting an external lesion. A computed tomography scan revealed a right seminal vesicle mass. Transrectal ultrasound guided biopsy returned a tissue diagnosis of schwannoma. To aid in operative planning, magnetic resonance imaging of the prostate and pelvis was obtained with and without contrast. This defined a 5x4x4 cm(3) mass abutting the right seminal vesicle without evidence of invasion into adjacent structures. The patient underwent an elective robotic-assisted laparoscopic resection of the mass. Final pathology demonstrated a completely excised schwannoma arising from the soft tissue adherent to the right seminal vesicle.