成人睾丸良性占位病变的诊断与治疗选择（附16例报告）

Diagnosis and treatment options on benign testicular tumor in adults

目的探讨成人睾丸良性占位病变的诊断与治疗选择。方法对2003—2010年诊治的16例睾丸良性肿瘤的临床资料及随访情况进行回顾性分析。结果16例睾丸肿瘤病例术前经超声、CT或MRI、AFP和p—HCG检查，诊断13例考虑为良性病变，3例可疑恶性。术中行冰冻切片检查10例，其中7例行睾丸部分切除术，3例性质不定行睾丸根治性切除术。6例未行术中病理检查直接行根治性睾丸切除。术后经病理诊断睾丸间质细胞瘤2例，成熟畸胎瘤4例，腺瘤样瘤3例，平滑肌瘤3例，皮样囊肿1例，混合肿瘤3例。术后随访2个月－12年均未出现复发及转移。结论睾丸良性占位的术前诊断对手术处理方式选择非常重要，B超、CT或MRI、肿瘤标记物以及术中冰冻切片活检均具有临床诊断价值。睾丸良性肿瘤的治疗应首选保留睾丸的肿瘤切除。

Objectives To analyse the diagnosis and treatment options on benign testicular tumor in adults. Methods A retrospective analysis of clinical data and follow - up outcome in 16 cases of benign testicular tumor from 2003 to 2010. Results In the 16 cases of testicular tumor, ultrasonograph, CT or MRI, AFP and β- HCG were performed before surgical treatment, 13 cases were considered to be benign tumor, 3 cases were suspected. 10 cases were performed with intraoperative frozen biopsy examination, including 7 cases were performed with local resection of testicular tumor, and 3 cases were performed with radical resection because of uncertain malignancy. 6 cases were performed with radical resection without intraoperative frozen biopsy. Postoperative pathological diagnosis showed leydig cell tumor （2 cases）, mature teratoma （g cases） , adenomatoid tumor （3 cases）, leiomyoma （3 cases）, dermoid cyst （ 1 cases） and mixed tumor （3 cases）. Recurrence and metastasis were not found in all the cases after 2 - 12 months follow - up. Conclusions , Preoperative diagnosis of benign testicular mass is very important to the options of surgical treatment. All the examinations including ultrasonograph, CT or MRI, tumor markers and intraoperative frozen biopsy have diagnostic value. Local resection of testicular tumor with reservation of testis should be the first choice to the treatment of benign testicular tumor.