原发性附睾肿瘤的诊断与治疗

The diagnosis and treatment of primary tumor in epididymis

目的:提高原发性附睾肿瘤的诊治水平,进一步认识附睾恶性肿瘤的生物学行为及可行的诊断和治疗方法。方法:回顾性分析我院1998～2003年12月收治的6例原发性附睾肿瘤患者的临床资料:5例为附睾良性肿瘤,其中2例行肿块切除,3例行附睾切除。1例为附睾小圆细胞高度恶性肿瘤,行患侧睾丸附睾切除术并精索高位切断,术后用DDP80～100mg/m2加VP16300mg/m2加IFO5.0mg/m2方案化疗,三个疗程后行放疗三个疗程。结果:5例良性肿瘤患者随访至今无一例复发;1例小圆细胞高度恶性肿瘤已随访12个月未见明显转移。结论:附睾良性和恶性肿瘤无特异性,术前诊断仍应综合病史、体检、影像学检查确定。附睾恶性肿瘤的组织来源复杂,其病理学诊断往往需结合组织化学、电镜观察进行,必要时需作遗传学和基因学诊断。手术是治疗良性和恶性附睾肿瘤的首选方法。

Objective:To improve the diagnosis and treatment of primary tumor in epididymis.Methods:Clinical data of 6 cases with primary tumor in epididymis were reviewed and discussed with reviewing literature. 5 of our 6 cases were benign tumor and received resection of epididymis or the mass. Another case was malignant: pathologic examination revealed malignant small round cell tumor of epididymis .Results:No recurrence was noted in all the 5 cases of benign tumor of epididymis. The malignant case have been followed up for 12 months without detectable recurrence or metastasis.Conclusions:The difference of clinical characters between benign and malignant tumor of epididymis is not obvious, Combination of history , physical examination ,and radiological examination especially color doppler ultrasonography are needed for diagnosis . The origin of malignant tumor of epididymis is complicated pathologically. Examination of histochemisty, electron microscope, or even genetics examination may be needed. Surgical resetion is the treatment of choice.