35例睾丸良性肿瘤的临床病例分析

Clinical analysis of 35 cases of benign testicular tumors

目的:探讨睾丸良性肿瘤行保留睾丸手术的治疗效果、预后及其影响因素。方法:回顾性分析2004年5月至2017年5月中山大学肿瘤防治中心35例睾丸良性肿瘤患者的临床病例资料,分为保留睾丸手术组和根治性睾丸切除术组。结果:35例患者平均年龄为18.8(0.4~44.0)岁,其中14例(40.0%)行保留睾丸手术、21例(60.0%)行根治性睾丸切除术。两组患者的肿瘤大小分别为1.8(0.4~4.0)cm和2.7(1.0~8.0)cm,围手术期均未见明显并发症,且均治愈出院。术后病理为表皮囊肿18例、成熟型畸胎瘤10例、间质细胞瘤4例和腺瘤样瘤3例。10例患者行术中冰冻快速病理检查,均与石蜡病理结果相符。行保留睾丸手术的患者,随访期间均未发现复发及转移,且性功能和生育能力保存良好。结论:保留睾丸手术是可靠的,肿瘤的大小影响其实施。对于术前诊断考虑良性或性质不定的睾丸肿瘤,应行术中冰冻快速病理检查,确定为良性者行保留睾丸手术,否则行根治性睾丸切除术。

Objective： To explore the postoperative effect, prognosis, and prognostic factors for benign testicular tumors. Methods： We retrospectively analyzed the clinical data of 35 patients with benign testicular tumors between May 2004 and May 2017 from Sun Yatsen University Cancer Center, and the patients were followed up until October 2017. Results： The mean age of the 35 patients was18.8（0.4-44.0） years. Among them, 14 patients（40.0%） underwent testis-sparing surgery and 21（60.0%） underwent radical orchiectomy, and the tumor sizes were 1.8（0.4-4.0） cm and 2.7（1.0-8.0） cm, respectively. All patients had been cured without obvious perioperative complications. Postoperative histopathological tumor types included 18 epidermal cysts, 10 mature teratomas, 4 interstitial cell tumors, and 3 adenomatoid tumors. Frozen section examination of 10 cases had been operated, and all results were consistent with paraffin pathology. No patient who underwent testis-sparing surgery showed recurrence and/or metastasis during follow-up, and their sexual function and fertility were well preserved. Conclusions： Testis-sparing surgery is reliable, and the size of the tumor determines its implementation. An intraoperative rapid frozen section examination should be performed in patients with testicular neoplasms of a benign or variable nature diagnosed before operation. Patients with benign testicular tumors should undergo testis-sparing surgery,whereas others should undergo radical orchiectomy.