原发性附睾肿瘤（附24例报告）

Primaryepididymaltumors:reportof24cases

附睾肿瘤少见，易与其他疾病混淆，故作者对１９８３年至１９９５年６月２４例原发性附睾肿瘤进行报告。其中良性２３例，恶性１例。６６．７％肿瘤位于附睾尾部，１２．５％位于尾体部，双侧性１例为平滑肌瘤，多发性１例为腺样瘤。作者认为附睾肿瘤症状轻微或缺如，易与附睾其他性质肿物相混淆，良性应与附睾结核、慢性炎症或肉芽肿等鉴别。恶性肿瘤除有恶性肿块特征外，常出现精索增粗，并以输精管增粗为主。良性附睾肿瘤作附睾切除或单纯肿瘤切除，术后无复发，预后良好。恶性肿瘤应与睾丸精索恶性肿瘤同样对待，并根据病理类型加用化疗和放疗，以提高疗效。

casesofprimaryepididymaltumorsincluding23benignand1malignanttumorsweretreated.Inthesecases,66.7%situatedatepididymaltail,and12.5%involvedbothtailandbody.Smoothmuscletumorofonecasewasbilateral,andadenomatoidtumorofanotheronewasmultiple.Thesymptomsofprimaryepididymaltumorsweremildevenabsent,sothetumorwaseasilyconfusedwithnon-tumorousmasofepididymis.Benignepididymaltumorshouldbediferentiatedfromtubercu-losis,chronicinflammationorgranuloma.Besidessignsofmalignantmass,malignantepididymaltumorusualyshowedthickenedspermaticcord,especialyenlargedductusdeferens.Theremovalofthetumormassorwholeepididymisofthesamesidecouldcurebenignepididymaltumorwithoutrecurence.Ma-lignantepididymaltumorshouldbetreatedasmalignancyoftestisorspermaticcord,withadjuvantchemotherapyorradiotherapyasindicatedbythepathologicaltype.