小儿卵黄囊瘤的诊断与治疗

Diagnosis and treatment of yolk sac tumor in children

目的 总结18例儿童卵黄囊瘤手术治疗和化疗的临床经验,分析探讨与预后的关系.方法 回顾性分析我院1992年4月至2009年12月收治的18例儿童卵黄囊瘤的病例资料.男12例,女6例,依据临床表现、影像学所见和血AFP水平升高,做出临床诊断.原发部位：睾丸10例,卵巢3例,骶尾部4例,腹部1例.结果 11例完全切除及BEP方案化疗;5例未完全切除、化疔;1例完全切除、未化疗;1例未完全切除也未行化疗.随访8～24个月,监测影像检查及血AFP水平变化,除1例放弃治疗外,全部患儿存活良好,未出现复发或转移.结论 在儿童卵黄囊瘤的治疗中手术与化疗相结合可以达到良好的疗效.

Objective To review our experience of managing yolk sac tumors in children. Methods Clinical data of eighteen patients with yolk sac tumors admitted in our department from April 1992 to December 2009 were reviewed retrospectively. There were 12 boys and 6 girls. The diagnoses were based on diagnostic imaging and elevated serum AFP levels. Of the 18 cases, 10 were located in testes,3 in ovaries,4 in sacrococcygeal region and 1 in the abdomen. Results Eleven patients were treated with complete excision and BEP chemotherapy; 5 pateints underwent subtotal resections and chemotherapy; one complete excision without chemotherapy; one patient refused treatment. Followedup of 8-24 months revealed that all children, except for the untreated case, survived uneventfully, without any sign of recurrence or metastasis. Conclusions The combination of surgery and chemotherapy can achieve good prognosis in children with yolk sac tumors.