睾丸鞘膜纤维性假瘤(附5例报告)

Fibrous Pseudotumor of Testicular Tunic(Report of 5 Cases)

目的:提高对睾丸鞘膜纤维性假瘤的认识及诊疗水平。方法:回顾性分析1994年3月～2009年6月收治的5例睾丸鞘膜纤维性假瘤的临床资料;5例患者均以发现阴囊内肿块而入院,体检发现睾丸和附睾旁数个大小不一的类圆形结节,结节质韧,无压痛,活动度好,无粘连;B超发现结节为实性低回声光团、无明显血流信号;5例均行手术治疗。结果:1例行睾丸、附睾及多发性结节切除术,4例行保留睾丸、附睾的多发性结节和睾丸鞘膜切除术,1例术中快速冷冻切片为炎性假瘤,术后病理结果均为睾丸鞘膜多发性纤维性假瘤,随访1～5年无复发。结论:睾丸鞘膜纤维性假瘤是一种少见的阴囊部位良性肿瘤样病变,提高认识后诊断不难,治疗上行保留睾丸、附睾的多发性结节和睾丸鞘膜切除术即可,无需行睾丸附睾切除术。

Objective：To increase the recognition of fibrous pseudotumor, and the diagnosis and treatment of this disease. Methods：Clinical data of 5 patients with fibrous pseudotumor who were admitted to our hospital from March 1994 to June2009 were analyzed retrospectively. The five patients were hospitalized due to masses found in the scrotum. During the examination, circular nodules of various sizes which were palpable in the areas of the tes- tis and epididymis, were tough, nontender, movable and nonadhesive. Ultrasonography revealed a solid echogenci mass of low level echo which had no obvious blood flow signals. All the 5 palients underwent surgical treatment. Results： Resection of multiple nodules as well as the testis and epidimymis was performed in one patient. Four patients were subjected to the excision of muhiple nodules and the perididymis with reservation of the testis and epi- didymis. In 1 patient, pathological examination on the rapid frozen slides during the operation showed inflammatory pseudoturnor, and multiple fibrous pseudotumor was confirmed in the perididymis in all cases after the operation hy pathological examination. All the patients were followed for 1 to 5 years. Conclusions： Fibrous pseudotumor originating in the perididymis is a rare benign neoplasm. Establishing the diagnosis of fibrous pseudotumor is not very difficult after the recognition of this disease. Resection of multiple nodules as well as the perididymis rather than orchidoepidymectomy is the treatment of choice for this disease.