小儿特殊生长方式睾丸横纹肌肉瘤一例诊疗分析及文献复习

Diagnosis and treatment of testicular rhabdomyosarcoma with special growth patterns in children：a case report and literature review

目的通过文献和病例回顾及复习，探讨小儿特殊类型睾丸肿瘤的流行病学特征、临床表现和诊治方法。方法回顾性分析1例以左侧腹股沟斜疝及左侧睾丸肿物术后7 d肿胀为代主诉入院的5岁患儿的临床资料，同时分析该睾丸肿瘤患儿的发病、诊断和治疗过程，并对相关文献进行复习分析。结果本例患儿术中快速冰冻病理结果显示：（左侧睾丸占位）镜下见大部分为梭形细胞，其间有片状或散在的泡沫样细胞，部分细胞有异型，倾向梭形细胞肿瘤，细胞来源及肿瘤性质不能明确，需免疫组化协诊。故术中保留睾丸及精索，术后5 d根据常规病理结果诊断为横纹肌肉瘤，择期进行根治性睾丸及精索切除术，术后常规进行化疗，同时结合国内外相关文献进行详细分析。结论手术治疗是睾丸肿瘤的首选治疗方式，术中应根据具体情况选择手术方式，除良性肿瘤以外的睾丸肿瘤术后都应常规进行化疗。

Objective To investigate the epidemiological characteristics, clinical manifestations, diagnosis and treatment of children with special types of testicular tumors by literature review and case study.Methods Clinical data of one case of 5-year old children with left inguinal hernia and left testicular swelling 7 days after operation as deputy chief complaint of admission were analyzed, at the same time, the pathogenesis, diagnosis and the treatment process of the testicular tumor in the child were analyzed, and the relevant literature was reviewed.Results The results of rapid frozen surgery in children showed that： （left testicular mass） most of the cells were spindle cells through microscope, among which there were flaky or scattered foam-like cells; some cells had abnormal shape, indicating the presence of spindle cell tumors, while the source of cells and the nature of the tumor cannot be determined, which need immunohistochemical consultation. Therefore, during surgery, we retained testes and spermatic cord. Five days after surgery, rhabdomyosarcoma was diagnosed on the basis of routine pathological findings, and radical testicular and spermatic cord resection were performed at a designated time. After the surgery, the children was treated by routine chemotherapy. At the same time, we conducted a detailed analysis combining relevant literature at home and abroad.Conclusions Surgical treatment is the first choice of treatment for testicular cancer. The surgical approach should be selected according to the specific situation. All the testicular tumors except routine benign tumors should be treated by routine chemotherapy.