睾丸原发性卵黄囊瘤临床病理分析(附8例报告)

Primary testicular yolk sac tumor: Clinicopathological study of 8 cases

目的：探讨睾丸原发性卵黄囊瘤的临床病理特征、诊断、治疗及预后。方法：运用光镜、免疫组化对8例睾丸原发性卵黄囊瘤进行检测。结果：8例睾丸原发性卵黄囊瘤来自我院1998—2013年诊治的病例（2例为外院会诊病例），占我院同期睾丸生殖细胞肿瘤的10．7％（8／75），患者年龄7～43岁，平均23．9岁，8例患者临床表现均为患侧睾丸无痛性肿大，均发生于单侧睾丸。组织学：全部病例肿瘤组织均见微囊或网状结构和嗜酸性透明滴，而作为本瘤结构的S—D小体有5例。8例中仅1例为单纯性卵黄囊瘤，其余7例均为混合性卵黄囊瘤。免疫表型：AFP为其特征性标记物。结论：原发于睾丸的卵黄囊瘤是罕见的恶性肿瘤，术前AFP检测有助诊断，确诊依赖于病理检查。以手术加放、化疗的综合治疗措施，可以延长生存期。

Objective： To investigate the clinicopathological characteristics, diagnosis and treatment of primary testicular yolk sac tumor （YST）. Methods： We studied 8 cases of primary testicular YST by microscopy and immunohistochemistry. Results： The 8 cases of primary testicular YST, including 2 consultation cases, were confirmed from 1998 to 2013, accounting for 10.7% （ 8/75 ） of all the testicular germ cell tumors diagnosed in our hospital. The patients ranged in age from 7 to 43 years, 23.9 years on average. The main clinical manifestation of the patients was painless unilateral testis swelling. Microscopically, reticular tissues, schiller-duvaI （S-D） bodies, and eosin-stain transparent bodies were seen in the tumors. One of the cases was confirmed to be simple YST, while the other 7 mixed YST. AFP was a characteristic immunophenotype marker of the tumors. Conclusion ： Primary testicular YST is a rare malignancyr with poor prognosis. Its diagnosis depends on preoperative AFP test and postoperative pathology. Compre- hensive treatment, including orchiectomy, chemotherapy, and radiotherapy, can prolong the survival of the patients. Natl J Androl, 2014, 20 （5） ： 435 -438