原发性前列腺滑膜肉瘤的诊断和治疗(附1例报告及文献复习)

The diagnosis and treatment of primary prostate synovial sarcoma(Report of 1 cases and literature reviewed)

目的:探讨前列腺滑膜肉瘤的影像学特点、临床病理和诊治方法。方法:对1例原发性前列腺滑膜肉瘤的临床诊治资料进行回顾性分析。该例患者行超声、CT、MRI检查。手术后病理证实(免疫组化)。结果:该患者行前列腺肿瘤根治性切除术。病理:镜下所见异型性细胞片状分布,免疫组化:CK34(+),CD99(+),Ki67(+),MYOD1(+/-),Actin(+),CD117(+),dog-1(+/-),Vimentin(+)。诊断原发性前列腺滑膜肉瘤随访6个月,患者存活。结论:原发性前列腺滑模肉瘤临床罕见,确诊依赖病理及免疫组化检查。应与梭形细胞肿瘤、恶性神经鞘瘤、横纹肌肉瘤、间质肉瘤鉴别。治疗以手术为主,需根据肿瘤分级分期决定手术方案及术后是否需行辅助治疗。

Objective：To investigate the imaging characteristics, the clinical pathological features and the man- agement of prostate synovial sarcoma. Method：One patient underwent primary prostate synovial sarcoma was ob- served and analyzed retrospectively. This patient was diagnosed with ultrasound,CT and MRI examination. The diagnosis was confirmed by pathological findings （immunohistochemieal examination） after operation. Result： This patient underwent the radical prostatectomy. Pathological microscopically saw atypia cells patchy distribution. In Immunohistochemical essay.. CK34（＋）,CD99（＋）,Ki67（＋）, MYODI（＋/-）, Actin（＋）, CDl17（＋）, dog-1 （＋/- ）, Vimentin（ ＋ ）. This patient was diagnosed as primary prostate synovial sarcoma. The patient was still a- live for 6 months since the operation. Conclusion：primary prostate synovial sarcoma is an uncommon disease. Di- agnosis depends on pathology and immunohistochemical examination. It should be identified with spindle cell tumors, Malignant schwannoma, Rhabdomyosarcoma and stromal sarcoma. Treatment is mainly by operation tumor grade and stage influence operation scheme decision and whether adjuvant therapy is required after opera- tion.