小儿睾丸畸胎瘤35例临床分析

An analysis of 35 cases of testicular teratoma in children

目的总结小儿睾丸畸胎瘤的诊治经验。方法回顾性分析首都儿科研究所外科2001年6月-2013年4月收治的小儿睾丸畸胎瘤患儿35例，平均年龄3．6岁（1个月～10岁）。多以缓慢生长的阴囊无痛性肿块就诊，其中成熟畸胎瘤32例（91％）；不成熟畸胎瘤3例（9％）。结果全部患儿完整切除肿瘤，肿瘤切除率100％，其中保留睾丸手术33例（94％），睾丸全切2例（6％）。术中冰冻切片病理检查与术后石蜡切片病理检查符合率100％。术后平均随访时间75（5～142）个月，均无复发，血清甲胎蛋白（AFP）正常，睾丸生长发育良好，无睾丸萎缩坏死发生。结论术前详细询问病史，仔细查体，AFP检测，B超、CT、MRI等影像学检查能够做出比较明确的临床诊断，术中冰冻病理检查有助于手术方式的选择；对于有部分正常睾丸组织的睾丸畸胎瘤患儿行保留睾丸手术是实用、可行的。

Objective To analyse the diagnosis and treatment of pediatric testicular teratoma. Methods Capital Institute of Pediatrics database was analyzed for testicular tumors from June 2001 to April 2013 were concerning clinical presentation, treatment and therapeutic results. The data of 35 cases of pediatric testicular teratoma in Capital Institute of Pediatrics from June 2001 to April 2013 were reviewed retrospectively. Patients average was 3.6 years （from one month to ten years ）. The main clinical manifestation was a painless mass in scrotum which grew slowly. It was made definite diagnosis by frozen section analysis during the operation, of which, 32 were mature teratoma （91%） and 3 immature teratoma （9%） pathologically. Results All tumors were removed surgically. Thirty-three patients（94% ） underwent testiclular sparing-surgery, 2 patients （6%） underwent testicular resection. Fast frozen section histology during operation was correlated with the final pathohistological reports. All patients were followed up for 5-142 months（ mean =75 months）without evidence of recurrence and serum AFP level were in normal ranges. The operated testes grew and developed well, no testicular atrophy or necrosis. Conclusions With the careful examination, serum AFP level, imageological examination including B ultrasonic, CT, MRI, testieular teratoma could be diagnosed preoperatively. Fast frozen section histology help to choose operation procedure. Testiclular sparing surgery is feasible option to patients in testicular teratoma children if some testicular tissue can be reserved.