睾丸类癌一例报告

患者,43岁.因右侧阴囊肿胀疼痛1周于2006年6月16日入院.查体:右侧阴囊内可触及7 cm× 4 cm×4 cm肿块,质硬、有压痛,睾丸、附睾触摸不清,透光试验(一).左侧睾丸、附睾未见明显异常,腹股沟及浅表淋巴结无肿大.B超示右侧睾丸形态饱满,内见49 mm×36 mm实质性不均质团块,肿块内彩色血流偏少,探及高阻动脉频谱;CT示右侧睾丸增大、密度不均,肿瘤增强后病灶明显不均匀,中央可见低密度无强化区.临床诊断:右睾丸肿块.硬膜外麻醉下行右睾丸根治性切除.手术顺利.     

精索炎症性肌纤维母细胞瘤一例报告

患者,50岁.因左阴囊内无痛性包块5年,逐渐增大,于2010年1月21日入院.查体:左阴囊上方精索增粗如拇指,质硬,无触痛,附睾头体部增大,与睾丸分界不清.超声检查左阴囊内无回声,深2.6 cm.左附睾头体交界处旁见一低回声,约1.7 cm×1.7 cm,边界模糊,其内回声不均,与精索及附睾结构界限不清.左精索走行区结构紊乱.CT检查示左阴囊肿胀,其内见不规则软组织密度影,增强后明显强化.对侧阴囊内无异常.诊断:左精索肿瘤.行左精索、睾丸及附睾切除术.术中见左睾丸上方精索内质硬肿物,界限清,肿瘤近端精索正常.病理检查:左精索内不规则肿物,4.0 cm×3.0 cm×2.0 cm大小,质硬,局部见肿物侵及睾丸及附睾,切面呈鱼肉样.附睾炎性充血,睾丸正常.镜下肿瘤组织呈束状或编织状排列,细胞呈梭形,核多形性,染色深,偶见核分裂象,胞质红染.肿瘤细胞Bcl(一),Actin(sm)、β-cat、CD34、CD68、Desmin(+).诊断:左精索炎症性肌纤维母细胞瘤.术后未行其他辅助治疗,随访3个月未见复发.     

睾旁胚胎型横纹肌肉瘤5例报告并文献复习

目的:提高睾旁胚胎型横纹肌肉瘤的诊治水平。方法:回顾性分析5例睾旁胚胎型横纹肌肉瘤患者的临床资料,结合文献复习进行讨论。结果:5例患者中精索胚胎型横纹肌肉瘤2例、附睾胚胎型横纹肌肉瘤2例、鞘膜横纹肌肉瘤1例,临床病理分期Ⅰ期2例,Ⅱ期1例,Ⅳ期2例。5例患者最终均行根治性睾丸切除术及肿块完整切除术。1例Ⅰb期和1例Ⅱ期患者术后采用异环磷酰胺、长春新碱、足叶乙甙、丝裂霉素、顺铂化疗并配合局部放疗,余3例未行进一步治疗。2例Ⅰ期、1例Ⅱ期患者随访28、18、12个月未见复发和转移,1例Ⅳ期患者随访6个月后死于多发转移,1例Ⅳ期随访6个月未见复发和转移,后失访。结论:早期诊断,根治性手术并辅助化疗、放疗是治疗睾旁胚胎型横纹肌肉瘤的有效手段。     

睾丸鞘膜血管瘤一例

患者男性,81岁,因疑诊＂乙状结肠癌＂就诊,入院查体发现右侧阴囊有一质硬肿块,表面光滑,活动度好,透光试验阴性,无压痛,未闻及血管杂音,双侧精索无增粗,输精管无串珠样变.追问病史,五十多年前阴囊突然肿大,此后未消退,发病前无外伤史.行彩超检查示右睾丸肿瘤可能,彩色血流示右睾丸内血流信号无明显增多.予行右侧睾丸切除术,术中见右侧阴囊内被一大小约13cm×8cm×8cm的肿块占据,质硬,呈黄褐色,包膜完整,未见附睾,左侧睾丸、附睾轻度萎缩.     

男性生殖系统肉瘤8例诊治报告并文献复习

目的分析男性生殖系统肉瘤的临床特点,提高其诊治水平。方法对武汉协和医院2016-2019年收治的8例男性生殖系统肉瘤患者的病史、临床表现、影像学资料、病理诊断和随访结果进行回顾性分析,并复习近年国内外相关文献。结果8例患者均行扩大切除术,术后病理结果为:横纹肌肉瘤3例(其中会阴部泡状横纹肌肉瘤、睾丸附睾横纹肌肉瘤及阴囊胚胎性横纹肌肉瘤各1例)、阴囊高分化脂肪肉瘤2例、阴囊上皮样肉瘤1例、阴囊中度恶性黏液纤维肉瘤1例、阴茎包皮系带多形性皮肤肉瘤1例。随访时间13~47个月,1例出现全身多发转移,于术后1年死亡,1例失访,其余6例随访期内未见复发。结论男性生殖系统肉瘤极为罕见,有局部复发倾向,远处转移少见,主要采取以手术切除为基础的综合治疗手段。     

附睾横纹肌肉瘤一例报告

附睾横纹肌肉瘤少见 ,1996年我院收治 1例 ,报告如下。患者 ,49岁。右侧附睾肿物切除术后 2个月 ,发现复发 1个月入院。 2个月前无明显诱因发现右侧阴囊有一 2ｃｍ× 1ｃｍ肿物 ,无疼痛。当地医院诊断右附睾肿物 ,行右侧附睾切除术。术后2周发现右侧附睾手术处再发肿瘤 ,进行性增大 ,并牵扯右侧睾丸及右侧精索坠胀痛。入院查体 :右侧阴囊增大 ,右侧睾丸明显增大约 8ｃｍ× 5ｃｍ× 3ｃｍ ,与阴囊皮肤粘连紧 ,触痛明显 ,无明显波动感 ,双侧腹股沟未及肿大淋巴结。ＣＴ示 :阴囊内部分分叶状软组织块影 ,ＣＴ值 5 5 .2ＨＵ ,强化后ＣＴ值 6 2 .…     

尿路移行上皮细胞癌睾丸转移一例报告

患者,84岁.左侧阴囊内肿块进行性增大4个月于2005年10月20日入院.查体:左阴囊内扪及2 cm×3 cm肿块,质地较硬.B超示左阴囊内低回声肿块1.24 cm×0.96 cm,与附睾分界不清,左睾丸受压变形.诊断:左侧睾丸旁肿块.硬膜外麻醉下行探查术,术中见左侧睾丸旁肿块,质硬,与睾丸粘连紧密.行左侧睾丸高位切除术.病理报告:左睾丸低分化癌,血管内见癌栓.     

精索多形性脂肪肉瘤1例报告并文献复习

目的：分析并总结精索脂肪肉瘤患者的临床表现及其诊断及治疗方法。方法：回顾性分析我院收治的1例精索脂肪肉瘤患者的临床资料：左侧阴囊内有-9．0cm×9．4cm×6．7cm肿块,B超检查示左侧阴囊内存在一非均质实性包块;MRI显示左侧阴囊内有实质性肿瘤,未见肿大淋巴结。血清肿瘤标志物13-HCG、CEA、PSA和AFP检查均无异常。手术切除肿瘤的同时行左侧阴囊部分切除术。结果：术后病理检查提示为多形性混合型脂肪肉瘤。患者术后恢复顺利。结论：精索脂肪肉瘤是一种罕见的泌尿生殖系肿瘤,诊断主要依据病理检查结果确定;治疗以根治性睾丸切除术为主要方式,辅助放疗、化疗疗效不确切;预后与肿瘤组织病理类型密切相关,局部复发很常见,需长期随访。     

骨盆软组织侵袭性血管粘液瘤1例及文献复习

患者,男,39岁,因发现阴囊内肿物并逐渐增大5个月入院.入院后查体:外阴正常,左侧阴囊内可触及一6 cm×5 cm肿物,无触痛,可活动,质地中等,边缘光滑,与睾丸及附睾分界清楚,肿物根部未触及.彩超检查示双侧附睾及睾丸大小形态正常,阴囊下部一实性肿物,大小6.6 cm×7.0 cm×4.2 cm,界清,内部回声不均匀;CDFI:血流信号丰富,双侧腹股沟未见明显肿大淋巴结.于2010年5月4日在全麻下行左侧阴囊内肿物单纯切除术,术中见左侧睾丸、附睾正常,旁推左侧睾丸鞘膜及精索,见左阴囊内实性肿物约6 cm×5 cm,根部位于耻骨表面软组织上,可轻松将其剥离,术中及术后无明显出血.送检标本大小14 cm×7 cm×4 cm,分叶状,多结节状,大者8.0 cm×6.0 cm×3.5 cm,小者1.5 cm×1.0 cm×0.8 cm,切面灰白色,均质,鱼肉样,质略软.术后病理报告:侵袭性血管粘液瘤(aggressive angiomyxoma,AAM).免疫组化:CD34(+),S100(-),Ki-67阳性率19%,间皮素(-).术后未给予辅助性放疗、化疗或免疫治疗等.定期随访,未见复发及转移.     

右睾丸表皮样囊肿1例

患者,25岁,未婚,因右阴囊内肿物伴阴囊坠痛1年入院。半年前曾在当地行右精索静脉高位结扎术。患者否认有结核、外伤史。体检右附睾头压痛(±),近附睾头部睾丸内可及一约2×2cm大小肿物,质硬与睾丸分界不清,与阴囊皮肤无粘连。肛指前列腺无结节与触痛,OTT1:1000(++)1:2000(++),血常规尿常规血沉正常,胸片,IVP未见异常。诊断:右附睾、睾丸结核。抗痨治疗2月无效,在硬膜外麻醉下拟行右附睾、睾丸切除术。术中见右附睾头稍增大,质     

A case of paratesticular rhabdomyosarcoma

A case of paratesticular rhabdomyosarcoma in an 18-year-old male is reported. The patient was admitted for swelling of the right scrotum and right inguinal pain. Malignant tumor of the right testis was suspected and a high inguinal orchiectomy was performed. The pathological diagnosis was paratesticular rhabdomyosarcoma. Following retroperitoneal lymph node extirpation, chemotherapy, so-called CYVADIC therapy, consisting of cyclophosphamide, vincristine, adriamycin and dacarbazine was employed in 3 regions. The patient is in good health without recurrence 16 months after the surgery.     

A case of intrascrotal rhabdomyosarcoma

We report a case of intrascrotal rhabdomyosarcoma. A 15-year-old boy visited our clinic with the chief complaint of swelling of the right hemiscrotum. He had a history of fever and right hemiscrotal pain. With the initial diagnosis of acute epididymitis, the patient underwent medical therapy with antibiotics. One month later, because the mass had not responded to medical therapy, a right inguinal orchiectomy was done. Histologic examination revealed rhabdomyosarcoma. The patient received retroperitoneal lymph node dissection and combined chemotherapy with cyclophosphamide, bleomycin, actinomycin-D, adriamycin and vinblastine. He was well 5 years and 10 months postoperatively with no evidence of tumor recurrence or metastasis.     

Two cases of paratesticular rhabdomyosarcoma

Two cases of paratesticular rhabdomyosarcoma are reported. A 15-year-old boy was admitted in July, 1983, with a 3-week history of gradually increasing painless scrotal swelling on the right side. With the suspicion of testicular cancer, right radical orchiectomy was performed and pathological examination revealed an embryonal rhabdomyosarcoma of the paratesticular region. Chemotherapy and retroperitoneal lymphadenectomy were performed, and the latter revealed lymph node metastasis at the bifurcation of the aorta. Radiotherapy was not done because of adherent ileus. About 8 months after the orchiectomy, he died of recurrence at pelvic cavity and brain metastasis. A 6-year-old boy presented in March, 1985, with a complaint of right scrotal swelling that was painless and gradually increasing for about a month. Transinguinal exploration revealed a paratesticular neoplastic lesion and right radical orchiectomy was performed. Pathological diagnosis was paratesticular embryonal rhabdomyosarcoma. No evidence of metastasis was found by chest X-ray, excretory urogram, abdominal CT-scan or lymphangiography. As post-operative treatment, only chemotherapy was performed, and 9 months after the orchiectomy, the patient was asymptomatic. Ninety four cases of paratesticular rhabdomyosarcoma found in the Japanese literature are reviewed and mainly the policy of treatment is discussed.     

Simultaneous bilateral testicular tumors with different cell types: a case report

A 22-year-old man presented to our out-patient clinic with the chief complaint of a painless mass in the right scrotum and lymph node swelling around the abdominal aorta in October, 2002. The bilateral testicular tumors were palpated and visualized by ultrasound and magnetic resonance imaging (right phi5 cm, left phi2 cm in diameter). Computed tomography revealed a metastatic lymph node around the abdominal aorta (3 x 3 x 10 cm in size). He underwent bilateral radical orchiectomy after frozen storage. Enucleation of the left testicular tumor was not performed because of its irregular demarcation. Histological examination revealed typical seminoma of the right testis and embryonal carcinoma of the left testis. Retroperitoneal lymph node dissection was performed after 4 courses of systematic chemotherapy (bleomycin, etoposide, platinum). No viable tumor cells were present histologically in the excised lymph nodes. The postoperative course was good and uneventful at 16 months under androgen replacement therapy without disease recurrence.     

A case of intrascrotal rhabdomyosarcoma with para-aortic lymph node metastasis--complete response after multidrug chemotherapy

We report a case of intrascrotal rhabdomyosarcoma in a 59-year-old-male. The patient with a mass in the right scrotum was at first diagnosed with epididymitis and treated with antibiotics. The mass however, grew gradually and right orchiectomy revealed intrascrotal alveolar rhabdomyosarcoma. Para-aortic lymph node metastasis was pointed out by abdominal computed tomography. He received multidrug chemotherapy consisting of vincristine, actinomycin-D, cyclophosphamide, adriamycin, and cisplatin (IRS-III regimen 35). A complete response was obtained 3 months after the start of the chemotherapy. The patient is alive without recurrence 2 years after the surgery.     

Spindle cell rhabdomyosarcoma of the prostate

The spindle cell rhabdomyosarcoma is a rare variant of the embryonal rhabdomyosarcoma, mostly occurring in childhood. Only a few cases are described in adults. To date, no case of the spindle cell subtype of the prostatic embryonal rhabdomyosarcoma has been published. We report on a 23‐year‐old man, initially presenting with obstructive micturition problems, perineal pain and night sweat. After diagnosis by transrectal biopsy of the prostate, radiochemotherapy within the CWS 2002 P study was applied: nine cycles of vincristine, doxorubicin, actinomycin D, ifosfamide, and fractionated radiotherapy of the tumor and suspect lymph nodes (final dose 50.4 Gy). The tumor initially shrank, but an early local recurrence arose. Second‐line chemotherapy was applied, followed by a salvage radical cytoprostatectomy. The patient died of disseminated disease 14 months after diagnosis.     

A case of metastatic paratesticular rhabdomyosarcoma in an adult successfully treated with multidrug combination chemotherapy

A 20-year-old man was referred to our hospital with the complaint of a mass in the left scrotum. Computed tomography showed retroperitoneal lymph node metastases and multiple lung metastases. He underwent left high orchiectomy and was diagnosed with paratesticular embryonal rhabdomyosarcoma. He received combination chemotherapy consisting of cyclophosphamide, vincristine, doxorubicin, and dacarbazine. After four cycles of chemotherapy, lung metastases disappeared and lymph nodes decreased dramatically. He was alive without recurrence 31 months after the operation.     

Vaginal neoplasms in infancy: the combined role of chemotherapy and conservative surgical resection

This retrospective review of nine infants treated for vaginal tumors between 1964 and 1986 identifies the spectrum of lesions and examines the trend toward more conservative surgical therapy. Our patients' ages ranged from 1 to 30 months. Symptoms of vaginal bleeding or protruding tissue prompted examination under general anesthesia in all cases. Two children had benign protruding polypoid masses treated by simple excision. Seven had malignant tumors, two with endodermal sinus lesions and five with embryonal rhabdomyosarcoma. Early in this series, surgical therapy for embryonal rhabdomyosarcoma consisted of either anterior or complete pelvic exenteration, with adjuvant chemotherapy given in two of the three patients. One patient was operated on prior to the development of effective chemotherapy, and died of recurrent tumor 14 months after surgery. A second patient died from cardiac failure secondary to adriamycin toxicity 6 years after initial therapy. A third patient underwent total pelvic exenteration followed by successful reanastomosis of the colon to the anal verge. This patient, a female, is the oldest survivor and is free of disease 14 years after therapy. The most recent therapeutic approach used in two patients with embryonal rhabdomyosarcoma consisted of local tumor excision followed by postoperative chemotherapy. Both patients are alive and disease-free 9 and 11 years after therapy. Two patients with endodermal sinus tumor were treated with chemotherapy after simple excisional biopsy. They were then followed with serial vaginal biopsies at 3-month intervals. One required a partial vaginectomy for local recurrence 21 months after initial presentation. Both patients are alive and disease-free 18 months and 4 years after surgery.     

Primary bilateral testicular plasmacytoma: a case report

A 66-year-old man presented with swelling of the right testis where ultrasonography revealed a heterogeneous mass. The pathological diagnosis after right high inguinal orchiectomy was peripheral T cell lymphoma. Eighteen months later, the patient became aware of left testicular swelling and magnetic resonance imaging indicated recurrence of lymphoma. The pathology diagnosis after left high inguinal orchiectomy was plasmacytoma. Reevaluating the pathology of the previously resected right testicular tumor, we decided on the basis of positive immunostaining for CD38 and CD138 that the tumor in the right testis was also a plasmacytoma. Radiation therapy was applied to the left scrotum and the left inguinal area because plasmacytoma cells had invaded the spermatic cord. Multiple bone metastases and upper pharyngeal metastasis developed 5 months after the left orchiectomy, and in spite of multiple courses of combination chemotherapy the patient died of disseminated disease.