阴茎癌肉瘤一例报告并文献复习

目的：探讨阴茎癌肉瘤的组织学特点、临床表现、鉴别诊断、治疗及预后。方法：回顾性分析1例阴茎癌肉瘤患者的临床、病理和随访资料,并复习癌肉瘤及肉瘤样癌相关文献,对二者一并进行讨论。结果：术后病理检查见上皮源性及间叶源性两种恶性成分,癌组织CK5/6（＋）,P63（＋）,CK（＋）,CK8/18（＋）,但Vimentin（-）,肉瘤组织Vimentin（＋）,Ki-67约40%,诊断为阴茎癌肉瘤,术后未行进一步治疗。结论：阴茎癌肉瘤是具有高度侵袭性、高度致死性恶性肿瘤,往往首诊时已表现为高级别与高分期的特征,预后不良。确诊依赖病理学及免疫组化检查,手术为首选治疗方法。

A case report of penis carcinosarcoma and review of the literature

Objective： To investigate the histological features,clinical manifestation,differential diagnosis,treatment options and prognosis of penis carcinosarcoma. Methods： The clinical,pathological and follow up data of1 case of penis carcinosarcoma was reviewed,and the related articles of carcinosarcoma and sarcomatiod carcimoma were reviewed as a whole. Results： The post-operative histopathology of penis carcinosarcoma showed the tumor with epithelial and sarcomatoid mesenchymal components. The immumohistochemical test of the case was positive for CK5 /6,P63,CK,CK8 /18 and negative for Vimentin in epithelial cancer area,but positive for Vimentin in sarcomatoid area,and Ki-67 was about 40%. The final diagnosis was penis carcinosarcoma. There was no further treatment for post-operation. Conclusion： Penis carcinosarcoma have the biological behavior of invasive growth.They are often in an advance stage at first diagnosis,leading to an unfavorable prognosis. The final diagnosis depends on histopathology and immumohistochemical test,the first choice of treatment is operation.