前列腺间质肿瘤的临床特点及早期诊断策略：病例报告及文献复习

Clinical Features and Early Diagnosis Strategies of Prostatic Stromal Tumor:Two-case Report and Literature Review

目的探讨前列腺间质肿瘤的临床特点及诊断策略。方法收集2例前列腺间质肿瘤的病例并且回顾了相关评估此疾病临床特点及早期诊断策略的文献。1例是1位老年患者因排尿困难而至泌尿外科就诊,另1例老年患者是因排便困难而至普通外科就诊。2例患者的直肠指检结果表明前列腺的体积增大并有硬结,但是前列腺特异性抗原(PSA)却未明显升高。前列腺穿刺活检结果表明硬结中有大量的梭形细胞,免疫组化结果显示CD117(+),CD34(+),SMA(-),病理诊断为前列腺间质肿瘤。结果这2例报告说明前列腺间质肿瘤的临床特点主要是排尿困难,排便困难,经直肠前列腺超声检查发现前列腺体积增大并伴随着PSA的轻度升高或处于正常水平。前列腺穿刺活检在早期诊断前列腺间质肿瘤中发挥着极其重要的作用。结论对于前列腺有肿块并且PSA水平正常的患者,有必要进行进一步的检查。

Objective To investigate clinical features and early diagnosis strategies of prostatic stromal tumor. Methods We reported two cases of prostatic stromal tumor and reviewed related literatures to evaluate the clinical features and early diagnosis strategies. One aged man consulted urology doctor because of dysuria and the other man consulted general surgeon due to difficult defecation. Lump and enlargement of prostate volume were found by digital rectal examination in these two men, but prostate-specific antigen（PSA）was not elevated markedly. Prostate biopsy revealed predominance of spindle cell component, CDll7（＋）, CD34（＋）, and SMA（- ）were found by immunohistochemistry, and pathological diagnosis confirmed prostatic stromal tumor. Results The clinical features of prostatic stromal tumor were dysuria,difficult defecation,enlargement of prostate volume＇in transurethral resection syndrome, and slightly elevated or normal level of PSA. Prostate biopsy plays an important role in early diagnosis. Conclusion We can not give up further examination to patients with prostate mass because of normal PSA. Operation and regional radiotherapy are effective. Paracentetic suprapubic cystostomy and sigmoidostomy also can be considered in case of urine retention or intestinal obstruction.