睾丸内胚窦瘤4例报告

[目的]探讨睾丸内胚窦瘤的临床特点.[方法]4例均行患侧睾丸肿瘤根治术及腹膜后淋巴结清扫术(RPLND),术后辅以化疗.[结果]4例病理均提示为睾丸内胚窦瘤,术后2个月复查AFP均下降至正常.术后随访3～8年,无复发及远处转移.[结论]根治术加化疗能明显提高睾丸内胚窦瘤的治愈率.对儿童患者首选化疗,而不必常规行RPLND术.AFP可作为诊断及判断早期复发的指标.     

成人睾丸内胚窦瘤的临床分析

目的 :总结成人睾丸内胚窦瘤的临床特点、治疗方法和影响预后的因素。方法 :对我院 1980年1月～ 1995年 12月收治的成人睾丸内胚窦瘤共 11例进行回顾性研究。结果 :临床Ⅰ、Ⅱ期患者经规范治疗 ,可获较好的治疗效果。结论 :临床分期、手术方式与预后关系密切 ,术后的多药联合规范化疗和 /或放疗是防止复发的重要因素。AFP的动态观察可判断肿瘤是否复发和转移     

成人睾丸内胚窦瘤的临床分析

目的：总结成人睾丸内胚窦瘤的临床特点，治疗方法和影响预后的因素，方法：对我院1980年1月－1995年12月收治的成人睾丸内胚窦瘤共11例进行回顾性研究。结果：临床I，Ⅱ期患者经规范治疗，可获较好的治疗效果。结论：临床分期，手术方式与预后关系密切，术后的多药联合规范化疗和／或放疗是防止复发的重要因素。AFP的动态观察可判断肿瘤是否复发和转移。     

成人睾丸内胚窦瘤综合治疗2例

睾丸内胚窦瘤又称卵黄囊瘤或胚胎性腺瘤,是来源于生殖细胞的非精原细胞瘤,是睾丸肿瘤中罕见的一种病理类型,其恶性程度较高,大多预后不良。我们收治2例,行单纯手术及化疗,现均已存活4年,现报告如下。临床资料病例1:男性,25岁,发现左侧睾丸无痛性肿块半年入院,4岁时有双侧隐睾下降固定手术史。查体:左侧睾丸8.0cm×7.0cm×7.0cm,左侧精索增粗,腹股沟区未及肿大淋巴结。CT提示左睾丸实性占位,CT值为37Hu,中心为水样密度,腹膜后未发现肿大淋巴结;AFP为650ug/L。2002年8月28日作左睾丸肿瘤根治术及腹膜后淋巴结清扫术,病理报告为睾丸内胚窦…     

卵巢内胚窦瘤临床特点与预后相关因素分析

目的分析卵巢内胚窦瘤的临床病理学特点,以及Bc l-2在卵巢内胚窦瘤中的表达,探讨影响该病预后的相关因素。方法回顾性分析辽宁省肿瘤医院1984年1月至2007年12月收治的76例卵巢内胚窦瘤患者的临床病理学资料,分析Bc l-2在卵巢内胚窦瘤中的表达,了解各临床病理因素对预后的影响。结果Ⅰ、Ⅱ、Ⅲ及Ⅳ期卵巢内胚窦瘤患者的5年生存率分别为91.8%、88.9%、39.5%及25.0%。年龄、组织学类型、术前血清中甲胎蛋白值水平、是否保留生育功能的手术方式、术前肿瘤大小并不影响该病的预后。以铂类为基础的化疗方案,化疗疗程数〉3,残余瘤直径≤2 cm和腹水量≤100 mL是影响预后的因素。Bc l-2在不同病理类型间表达差异有统计学意义（P〈0.05）,但Bc l-2并不是影响预后的独立因素。结论临床分期,以铂类为基础的化疗方案,化疗疗程数,残余瘤直径和腹水量是影响预后的因素。     

睾丸间质细胞瘤的临床分析

目的:探讨睾丸间质细胞瘤的临床特点,提高睾丸间质细胞瘤的诊断和治疗水平。方法:报告1例睾丸间质细胞瘤患者的临床资料,结合相关文献进行分析。结果:术中快速冰冻病理结果为良性睾丸间质细胞瘤,行保留睾丸的肿瘤剜除术,术后随访4个月未见肿瘤复发及转移。结论:睾丸间质细胞瘤是临床较为少见的一种肿瘤,术前诊断较为困难,确诊仍依赖术后病理组织学检查。治疗主要以手术治疗,传统的手术方法采用根治性睾丸切除术,然而对于青春期前患者、双侧辜丸间质细胞瘤等患者,特别是病理检查确诊是良性睾丸间质细胞瘤患者,可以施行保留睾丸的肿瘤剜除术,行肿瘤剜除术前应常规行快速冰冻病理检查。     

22例卵巢内胚窦瘤临床分析

２２例卵巢内胚窦瘤临床分析安阳市肿瘤医院王振玲，闫昕卵巢内胚窦瘤是妇科高度恶性肿瘤之一，死亡率高，由于手术和化疗的配合应用，预后已有转机。本文报告了我科自１９７８年１月至１９９２年１２月收治的２２例卵巢内胚窦瘤，均有病理证实，随访至１９９４年６月，无...     

卵巢内胚窦瘤11例临床病理分析

为了探讨卵巢内胚窦瘤的临床表现、治疗及预后,回顾性分析1989-03-2007-03我院收治的11例卵巢内胚窦瘤患者的临床及病理资料.11例患者均行手术治疗,4例Ⅰ期患者手术时保留了生育功能.10例术后辅以BEP、BVP等方案化疗.随访至2009-06,3例失访,2例死亡,6例健在且无复发及转移.2及5年生存率分别为87.5%(7/8)及83.3%(5/6).初步研究结果提示,卵巢内胚窦瘤早期患者只要对侧卵巢和子宫正常,可行保留生育功能手术,术后辅以BEP或BVP为主的化疗,治疗效果较好.     

小儿生殖腺内胚窦瘤临床病理及免疫组化研究

小儿生殖腺内胚窦瘤临床病理及免疫组化研究郑绍光柳州地区人民医院病理科（柳州５４５００２）内胚窦瘤又名卵黄囊瘤，是一种由胚外结构──卵黄囊发生的高度恶性的生殖细胞肿瘤［１］，多发生在卵巢和睾丸。现将我们活检７例１２岁以下小儿生殖腺内胚窦瘤作一回顾性分析...     

44例儿童青少年恶性生殖细胞肿瘤综合治疗结果分析

背景与目的:目前儿童青少年恶性生殖细胞瘤采用综合治疗,总生存率已达75%以上,然而,不同分期、病理类型和发病部位的患者有不同的预后。本文分析儿童青少年恶性生殖细胞瘤的临床特点、综合治疗的效果和影响预后的因素,并探讨其治疗策略。方法:对1997年1月～2005年12月中山大学肿瘤防治中心收治的儿童青少年恶性生殖系统肿瘤患者的临床表现、综合治疗疗效和不良预后因素进行分析;采用Kaplan-Meier法计算全组生存率。结果:44例患者中,25例行术后辅助化疗;1例单纯手术;18例行诱导化疗,其中7例患者化疗后肿瘤缩小行手术切除,2例原发纵隔绒癌伴多发转移患者化疗后行残留病灶放疗,1例术后腹腔转移和1例术后肺转移患者化疗后获得完全缓解,1例原发纵隔内胚窦瘤化疗后部分缓解,未做进一步治疗,6例患者化疗无效进展死亡。化疗的患者均采用含铂类化疗方案治疗2～7个疗程。中位随访时间32个月,全组3年总生存率为84.8%;Ⅰ Ⅱ期患者3年生存率为100%,Ⅲ期为83.3%,Ⅳ期为65.6%,复发患者为66.7%;初治生殖器内(睾丸和卵巢)肿瘤患者3年生存率为96.0%,生殖器以外肿瘤患者为61.0%。结论:手术联合含铂类药物化疗能明显改善儿童青少年生殖细胞瘤的疗效和生存率,但对Ⅳ期、复发转移和生殖器以外的生殖细胞瘤患者应探讨新的方案和增加剂量强度。     

Diagnosis of a contralateral second testicular carcinoma by F18-FDG PET

BACKGROUND: In testicular carcinoma the early diagnosis is very important because with an early therapy there are good chances for long-term survival (50-90%). Metastases of a testicular carcinoma are at first lymphogenous, hematogenous only in late stages. CASE REPORT: This is a case report about a 28-year-old man, whose testicular carcinoma (left testis) had already been operated on (unripe teratoma with parts of an embryonic carcinoma, an endodermal sinus tumor and a chorion carcinoma). Because of the elevated tumor marker AFP an FDG PET (F18-fluorodeoxyglucose positron emission tomography) investigation was made. CT (covering thorax, abdomen and pelvis) and ultrasound of the testis showed no pathological results. In the FDG PET a significant pathological FDG uptake in the right testis was found. Histology showed an unripe teratoma with parts of an embryonic carcinoma, an endodermal sinus tumor, and a chorion carcinoma. It was a second carcinoma of the contralateral testis. CONCLUSION: F18-FDG PET was a sensitive and reliable modality for diagnosis in this patient.     

The incidence of yolk sac tumor (endodermal sinus tumor) elements in germ cell tumors of the testis in adults.

The incidence of yolk sac tumor (endodermal sinus tumor) elements was studied in 147 germ cell neoplasms of the testis in adults observed over a 4 1/2-year period. Excluding 79 cases of pure seminoma, yolk sac tumor elements were found in 26 (38%) of 68 tumors; in 8 tumors the yolk sac tumor was the predominant element. Yolk sac tumor elements were found admixed with all other germ cell tumor elements. Tumors composed entirely of yolk sac tumor were not encountered. Fifteen (57%) of the 26 patients with tumors containing yolk sac tumor elements have died of their disease during the period under study, compared with 13 (31%) of the remaining 42 patients, suggesting that the prognosis of adults with testicular tumors containing yolk sac tumor elements is unfavorable. This is in contrast to the relatively good prognosis of infants and young children with testicular yolk sac tumor, and similar to the prognosis of female patients with ovarian yolk sac tumor. The results of the present study give further support to the view that yolk sac tumor (endodermal sinus tumor) is not adistinctive neoplasm of the infant's testis, but a germ cell neoplasm differentiating in the direction of yolk sac or vitelline structures, and occurring in the testis, ovary and extragonadal sites in common with other germ cell neoplasms.     

Retroperitoneal germ cell tumors in childhood. A clinical and pathologic study of 11 cases

During the last 54 years at the Children's Hospital 11 children (10 female, 1 male) had been treated for an extragonadal germ cell tumor arising in the retroperitoneum. There were eight teratomas (five mature, three immature), two endodermal sinus tumors and one tumor with a mixture of both components. Abdominal pain or discomfort was the usual presenting complaint, with the average age at diagnosis being 18 months. On physical examination, each child had a palpable abdominal mass usually localized in the upper quadrants. The finding of calcification, bone or teeth, on radiologic study was most helpful in establishing a preoperative diagnosis of teratoma. The preferred treatment for children with mature and immature teratomas is complete surgical resection; decisions regarding adjuvant therapy for patients with immature tumors must be evaluated on an individual basis. The prognosis remains guarded for children with unresectable primaries or those with endodermal sinus tumor. Of three tumor-related deaths, two were due to metastatic endodermal sinus tumor and one resulted from extensive local growth by immature teratoma. Successful management of children with endodermal sinus tumor requires surgery aimed at debulking or complete resection in combination with aggressive adjuvant chemotherapy.     

左半结肠癌左侧睾丸转移1例报告并文献复习

目的:探讨结直肠癌睾丸转移的临床特点、诊断、治疗与预后。方法:通过1例左半结肠癌左侧睾丸转移的报道,分析其临床资料并复习相关文献。结果:本例患者为30岁年轻男性,左半结肠低分化腺癌根治性术后1年余出现左侧睾丸肿胀坠痛,后经左侧睾丸根治性切除,免疫组化证实为大肠来源。结论:结直肠癌睾丸转移报道罕见,临床表现一般为睾丸肿胀或鞘膜积液等非特异性症状,诊断依靠病理学检查。治疗一般采取手术、放化疗,必要时联合分子靶向治疗等。结直肠癌睾丸转移患者确诊后平均生存时间为6~12个月。     

Embryonal carcinoma of the testis

Long-term survival rates were correlated with selected clinical features in 479 patients with embryonal carcinoma of the testis and 33 patients with endodermal sinus tumor (infantile embryonal carcinoma, yolk sac tumor). In the period 1977 to 1982 embryonal carcinoma accounted for 26.8% of newly diagnosed germ cell tumors and 43% of nonseminomatous germ cell tumors entered in the Centralized Cancer Patient Data System. Among patients with embryonal carcinoma, over 80% were diagnosed in the 15-to-34 year age group. Seventy-four percent of the patients had metastatic disease at the time of diagnosis, and 50% of these had distant metastases, attesting to the aggressiveness of embryonal carcinoma and its tendency to early hematogenous spread. Despite the highly malignant nature of the tumor, the overall 5-year survival rate with treatments used was an excellent, 88%. Survival was correlated with the extent of disease at the time of diagnosis; the 5-year actuarial survival rates for patients with localized, regional, and distant disease were 98%, 96%, and 74%, respectively. Endodermal sinus tumor was uncommon (1.8% of all testicular germ cell tumors), occurred predominantly in the younger age group (0-24 years), and in 50% of the cases was localized to the testis. The survival rate for the 33 patients with this form of tumor was slightly worse than for the "adult form" of embryonal carcinoma. The authors conclude that survival of patients with embryonal carcinoma has greatly improved over the last decade as a result of improved methods for early detection of metastatic deposits and the effectiveness of newer chemotherapies in the treatment of disseminated disease.     

mGPS预测宫颈癌术后患者预后的初步探讨

目的:评价改良Glasgow评分(modified Glasgow prognostic score,mGPS)联合其他临床资料评估宫颈癌(cervical cancer,CC)术后患者预后的临床价值.方法:回顾性分析200例宫颈癌术后患者数据,计算mGPS,将mGPS及其他临床数据纳入COX回归模型分析可能的预后因素...     

Ovarian endodermal sinus tumor during pregnancy

We present the rare case of a 31-year-old pregnant woman who underwent resection of a FIGO stage Ia ovarian endodermal sinus tumor at 7 weeks of gestation, and who received no additional treatment, before or after giving birth. She was delivered of a healthy male infant at 40 weeks of gestation, and exhibited no signs of recurrence 28 months after the primary operation. There are 14 previous reports of endodermal sinus tumors during pregnancy. The present case represents the first patient who gave birth to a healthy infant without receiving any additional treatment following surgery, indicating that an early-stage endodermal sinus tumor does not necessarily require adjuvant chemotherapy. Received: August 7, 1998 / Accepted: April 21, 1999     

阴茎上皮样肉瘤1例报告并文献复习

目的:探讨阴茎上皮样肉瘤的临床、病理特征、诊断、治疗方法及预后。方法:回顾性分析1例阴茎上皮样肉瘤患者的临床资料及诊治流程并结合文献复习。结果:69岁男性患者,因发现阴茎根部进行性增大包块3月入院就诊。下腹部CT示阴茎根部大小5.9 cm×5.6 cm×6.5 cm软组织肿块,倾向恶性肿瘤,肉瘤可能性大。行阴茎根部肿瘤切除术,术后病理诊断:镜下见肿瘤细胞呈圆形或卵圆形,染色深浅不一,部分呈空泡状,核仁明显。免疫组化染色结果:CK广谱（-）,vimentin（部分+）,EMA(大部分+),CD34(血管+),CD31(血管+),CD99(+),S-100(-),Bcl-2(-),HMB45(-),SMA(-),AFP(-)。术后患者恢复可出院,未行进一步治疗。术后7月患者发现左侧腹股沟出现进行性增大包块,术后10月患者复查盆腔CT示阴茎根部上份盆壁、左侧睾丸及左侧腹股沟区见多发软组织肿块,最大者位于左侧腹股沟区,大小约7.6 cm×6.8 cm,考虑局部复发并左侧睾丸、腹股沟转移,患者自行放弃行进一步治疗,最后随访日期为2018年1月。结论:阴茎上皮样肉瘤是一种罕见的阴茎间质恶性肿瘤,确诊依赖于病理学及特异性免疫组化染色结果,手术切除是其主要治疗方法,术后是否行放化疗治疗尚存争议,其易局部复发及区域淋巴结转移,总体预后较差。     

睾丸肿瘤91例诊治分析

 【摘要】　目的　总结睾丸肿瘤的诊断、治疗和预后情况。方法　对91例睾丸肿瘤患者的临床资料和随访结果进行总结、分析。结果　91例睾丸肿瘤患者中,18～40岁者占70.3 %（64／91）,91.2 %（83／91）为生殖细胞肿瘤。37例精原细胞瘤患者中18～40岁发病28例（75.6 %）,17岁以下无发病,60岁以上仅1例（2.7 %）。31例非精原细胞瘤患者中＜5岁和18～40岁的患者分别为5例（16.1 %）和21例（67.7 %）。8例间质性肿瘤中各年龄段均有发病,但均较少。混合性肿瘤患者中18～40岁发病占93.3 %（14／15）。睾丸肿瘤早期症状主要表现为一侧睾丸无痛性肿大或睾丸结节。治疗主要在根治性睾丸切除基础上采用腹膜后淋巴结清扫术、化疗、放疗等综合治疗措施。精原细胞瘤患者1、3、5年生存率分别为97.3 %、91.8 %、91.8 %,Ⅰ、Ⅱ、Ⅲ期睾丸肿瘤5年生存率分别为83.6 %、52.3 %、33.3 %。结论　睾丸肿瘤发病年龄高峰为18～40岁,不同病理类型发病年龄分布情况不同,预后与病理类型、分期有关,精原细胞瘤预后最佳,早期肿瘤生存期长。