恶性睾丸间质细胞瘤（2例报告并文献复习）

Malignant Leydig cell tumor of testis （Report of two cases and literatures review）

目的探讨恶性睾丸间质细胞瘤的诊断、治疗及预后。方法报告2例恶性睾丸间质细胞瘤患者的临床资料并文献复习。结果根据患者临床表现及相关检查结果，术前诊断睾丸间质细胞瘤。1例伴有肺部转移，1例患者出现腹膜后淋巴结肿大。2例均行病侧睾丸切除术，术后病理结果证实均为恶性睾丸间质细胞瘤。术后1例行放射治疗。术后随访8～21个月，1例术后9个月可见腹膜后淋巴结肿大。1例拒绝进一步治疗，随访8个月后失访。结论恶性睾丸间质细胞瘤比较罕见。通过患者术前睾酮、雌二醇等性激素水平的检查对恶性睾丸间质细胞瘤的诊断有重要意义。早期发现并行根治性患侧睾丸切除术是治疗恶性睾丸间质细胞瘤的有效方法；晚期肿瘤预后较差，放射治疗可以在一定程度上提高患者的生活质量。

Objective To analyze the diagnosis, treatment and prognosis of malignant Leydig cell tumor. Methods Two cases of malignant Leydig cell tumor of testis were reported and the related literatures were reviewed. Results The patients were diagnosed as Leydig cell tumor according to their clinical manifestations and examinational findings. One case was found to have lung metastasis and another patient swollen retroperitoneal lymph nodes. Two patients of malignant Leydig cell tumor were all confirmed by pathological analysis. During 8 to 21 months follow-up, one case received postoperative radiotherapy,and his sretroperitoneal lymph nodes were found to be swollen on 9th month. One patient refused further treatment and losed after 8 months. Conclusion Malignant Leydig cell tumor was a rare testicular tumor in clinic. Preoperative testosterone level and estradiol level were important biomarker for diagnosis of this disease. Ipsilateral radical orchiectomy was effective treatment method for early Leydig cell tumor. Radiational therapy might improve life quality of patient with advanced tumor.