恶性睾丸间质细胞瘤3例报告及文献复习

Malignant testicular Leydig cell tumor:case report and literature review

目的:探讨成人恶性睾丸间质细胞瘤的临床病理特点,明确适宜的治疗方式。方法:回顾性分析我院从1997年6月至2009年12月诊治的3例成年恶性睾丸间质细胞瘤患者,分析其临床资料包括症状体征、实验室检查、影像学检查、治疗方式、病理结果及随访情况。结果:3例患者均行睾丸根治性切除术。1例患者术后9个月出现淋巴结转移,13个月出现肺转移并于术后26个月死于肿瘤广泛转移;另2例患者术后即刻行腹膜后淋巴结清扫发现了CT未提示的腹膜后淋巴结转移,其中1例术后43个月出现肺转移。结论:部分成人睾丸间质细胞瘤呈恶性病程,需严密随诊。腹膜后淋巴结清扫术具有诊断价值,转移患者预后较差。

Objectives： To investigate clinical and pathological features of adult testicular malignant Leydig cell tumor（ LCT）, and to identify optimal treatment. Methods： Records of 3 malignant LCT patients diagnosed from Jun. 1997 to Dec. 2012 were collected. We retrospectively analyzed the clinical and pathological features, treatment and follow -ups. Results： All 3 patients underwent radical orchiectomy. One patient was detected with retroperitoneal lymph node metastasis 9 months after orchiectomy, and lung metastasis 4 months later. The patient died of metastatic disease 26 months after orchiectomy. The other 2 patients were detected with retroperitoneal lymph node metastasis during retroperitoneal lymph node dissection which were not detected by the preoperative CT scan. Conclusion ： Adult Leydig cen tumor patients need intensive surveillance because of its potentially aggressive malignancy process. Retroperitoneal lymph node dissection is effective in the diagnosis of lymph node metastasis. The prognosis of malignant Leydig cell tumor patients with metastasis was relatively not optimistic.