成人前列腺横纹肌肉瘤的诊治体会

Diagnostic experiences of adult prostatic rhabdomyosarcoma: with a report of 3 cases attached

目的 探讨成人前列腺横纹肌肉瘤的早期诊断、治疗及预后.方法 回顾性分析本科2005年1月~2011年12月收治的3例前列腺横纹肌肉瘤患者的临床资料.结果 2例行前列腺穿刺活检术确诊,1例行经尿道前列腺电切术后确诊,病理类型均为胚胎性横纹肌肉瘤.确诊后行回肠膀胱尿流改道术,术后给予辅助化疗及放疗.3例中,1例术后11个月因肿瘤多发性转移导致死亡;1例已存活1年,无复发及转移;1例术后转肿瘤科治疗,51 d后行CT复查时发现肺部转移,现已存活3个月,后两例目前正在随访中.结论 前列腺横纹肌肉瘤是一种高度恶性的肿瘤,早期诊断困难,进展迅速,预后差,确诊需依靠病理检查,提高诊治效果的关键在于早期诊断及尽早手术治疗.

Objective To discuss the early diagnosis,treatment, and prognosis of adult prostatic rhabdomyosarcoma. Methods Retrospective analysis was made in the clinical data of 3 cases of prostatic rhabdomyosarcoma hospitalized between January 1990 and December 2011. Results Two cases were definitely diagnosed by prostatic puncture biopsy, and the other one were diagnosed by TURP. The pathological types were all embryonal rhabdomyosarcoma. After the final diagnosis, all the patients received the ileal conduit diversion. After the operation, they also received the adjuvant chemotherapy and radiotherapy. Among the three cases, one was dead because of the multiple metastasis of the tumor 11 months after the operation; one survived for 1 year without any reoccurrence and metastasis;one was switched to the department of oncology. Pulmonary metastasis was found by the CT reexamination 5l days after the operation in that case who had survived for three months by the last follow-up. Conclusion Prostatic rhabdomyosarcoma is a kind of high malignant tumor. It is difficult to be diagnosed at the early stage and has rapid progress and poor prognosis. The final diagnosis depends on the pathological examination. The key points to improve the curative effect are early diagnosis and surgical treatment.