精索副神经节瘤2例并文献复习

Two cases of spermatic cord paraganglioma and literature review

2例患者均为男性,病例1为69岁,病例2为24岁,均因发现阴囊肿块就诊。病例1行根治性右侧睾丸切除术,病例2行肿块切除术。显微镜下2例均见肿瘤组织排列成巢团状及腺泡状,瘤细胞呈多边形,细胞质丰富、嗜伊红色或嗜碱性,细胞核深染,可见明显的异型核,但核分裂象罕见,间质富于薄壁血管。瘤细胞表达神经内分泌标志物突触素(synaptophysin,Syn)、嗜铬粒蛋白A(chromogranin A,CgA)及CD56,肿瘤周围支持细胞表达S-100蛋白。术后分别随访12和72个月,均未见复发及转移。精索副神经节瘤比较罕见,其确诊需要依赖组织病理学检查,必要时可行相关基因检测。目前,副神经节瘤已全部归为恶性肿瘤,手术切除治疗后需长期随访观察。

Two patients were male,with case 1 being 69 years old and case 2 being 24 years old.Both presented for medical consultation due to a scrotal mass.Case 1 underwent a radical right orchiectomy,while case 2 underwent excision of the mass.Under the microscope,both cases showed tumor tissues arranged in nests and acinar patterns.The tumor cells were polygonal with abundant cytoplasm,eosinophilic or basophilic,and had deeply stained nuclei with evident nuclear atypia,though mitotic figures were rare.The stroma was rich in thin-walled blood vessels.The tumor cells expressed neuroendocrine markers such as synaptophysin(Syn),chromogranin A(CgA),and CD56,while the supporting cells around the tumor expressed S-100 protein.Post-surgery,the patients were followed up for 12 and 72 months respectively,with no recurrence or metastasis observed.Spermatic cord paraganglioma is relatively rare,and its diagnosis depends on histopathologic examination with genetic testing being advisable when necessary.Currently,all paragangliomas are classified as malignant tumors,and long-term follow-up observation is required after surgical removal.