前列腺肉瘤7例临床分析

目的探讨前列腺肉瘤的诊断、治疗及预后因素。方法报道7例前列腺肉瘤患者的诊治方法和随访结果。结合文献讨论诊治方案。结果平滑肌肉瘤5例,横纹肌肉瘤2例。回肠膀胱术1例随访20个月后死于心脏疾病,巨大前列腺肉瘤摘除 双侧输尿管膀胱再植术1例现随访3个月存活,余5例均在16个月内死于远处转移。结论前列腺肉瘤预后差,长期存活依赖于早期诊断和以根治手术为主的综合治疗。     

前列腺肉瘤26例回顾性分析

目的:总结前列腺肉瘤的诊治体会,阐述其诊疗及预后特点。方法:回顾分析1998年6月至2018年3月收治的26例前列腺肉瘤患者的临床资料。患者年龄15～64(41±14)岁,血清PSA 0. 35～5. 21 (1. 76±1. 18)μg/L,分别经前列腺穿刺活检、经尿道前列腺电切及手术活检或切除确诊为前列腺肉瘤。结果:26例患者病理诊断为平滑肌肉瘤11例,横纹肌肉瘤6例,梭形细胞肉瘤4例,纤维肉瘤4例,未分化肉瘤1例。24例获得随访,2例失访;随访时间3～18个月,平均13个月。随访病例中21例患者确诊后12个月内死亡,3例患者确诊后13～18个月死亡,均因肿瘤多发远处转移死亡。结论:前列腺肉瘤临床罕见,恶性程度较高,预后差。手术切除仍是治疗的主要方法。临床上应多种方法联合诊断和治疗前列腺肉瘤。     

前列腺肉瘤14例报告

目的:探讨前列腺肉瘤的诊断及有效的治疗方法。方法:本院1991年1月~2004年6月共诊治前列腺肉瘤14例,对其临床资料进行分析。结果:前列腺肉瘤占同期收治前列腺恶性肿瘤的3.21%。患者年龄17~62岁,平均39.5岁;12例因排尿困难就诊。所有患者体检均发现前列腺质软肿块。10例行血清酸性磷酸酶(PAP)、碱性磷酸酶(AKP)及前列腺特异性抗原(PSA)检查,均正常。病理显示平滑肌肉瘤7例,横纹肌肉瘤1例,纤维肉瘤4例,梭形细胞肉瘤2例,不同类型前列腺肉瘤免疫组化染色有各自特征。临床分期:I期2例,II期5例,III期3例,IV期4例。均接受包括手术+放疗、和/或化疗等治疗。1例失访,11例于确诊后2~12个月内死亡。2例仍存活,其中1例无瘤生存至今18个月,1例带瘤生存至今2个月。结论:前列腺肉瘤首发症状为进行性排尿困难,直肠指检可以提示前列腺肉瘤,依靠前列腺穿刺病理学检查获得确诊,免疫组化染色有助于前列腺肉瘤的分类。该病预后极差,治疗方法以手术治疗为主,辅以放、化疗。     

成人前列腺肉瘤7例临床分析

目的 :探讨前列腺肉瘤的诊断、治疗及预后因素。　方法 :回顾性分析我院诊治的 7例成人前列腺肉瘤临床表现、实验室检查、治疗方案、病理类型及预后。　结果 :平滑肌肉瘤 3例 ,横纹肌肉瘤 3例 ,恶性神经鞘瘤 1例。前列腺肉瘤有膀胱颈梗阻为主的复合表现 ,确诊依靠病理诊断 ,病理分型与疾病的进展相关联。 2例行根治性膀胱前列腺切除术者于术后 13个月和 2 1个月死亡 ;2例行全盆腔脏器切除术辅以放疗和 (或 )化疗者 ,随访 15个月仍存活 ;3例仅行放疗和 (或 )化疗 ,平均于初诊后 7个月死亡。　结论 :前列腺肉瘤预后较差 ,早期诊断和完整的外科切除有重要意义 ,密切随访可以早期发现复发。     

前列腺肉瘤诊治分析(附4例报告)

目的:探讨前列腺肉瘤的诊断、治疗方法及其预后。方法:回顾性分析1999年10月～2011年10月收治的4例前列腺肉瘤患者临床资料,并对所有患者进行随访,就其诊治及预后进行研讨。结果:4例患者中,1例为横纹肌肉瘤,3例为平滑肌肉瘤。1例行根治性前列腺膀胱切除术及回肠膀胱术,术后1年未见复发转移;2例行耻骨上膀胱穿刺造瘘及放疗,分别于确诊后6、11个月死于远处转移;1例误诊为尿道狭窄,行尿道会师术,转入上级医院,3个月后死于脑转移。结论:前列腺肉瘤发展快,恶性程度高,预后差。长期存活取决于早期诊断和根治性手术为主的综合治疗。     

前列腺肉瘤的诊治分析（附8例报告）

目的：探讨前列腺肉瘤的诊断、治疗及预后。方法：回顾性分析1992年3月~2010年1月收治的8例前列腺肉瘤患者的临床资料,就其诊治及预后进行研讨。结果：8例患者中,横纹肌肉瘤2例、平滑肌肉瘤2例及粒细胞肉瘤、恶性间叶瘤、叶状囊肉瘤各1例,1例穿刺为问叶源性恶性肿瘤,未进一步分类。4例行根治性前列腺切除术,3例术后未行辅助治疗,分别于术后16、10、8个月死于远处转移,另1例失访;1例行根治性膀胱切除术,术后辅以规律化疗,无瘤存活至今16个月;3例未行手术治疗,依靠穿刺确诊,1例行辅助化疗后存活4个月,死于远处转移,其余2例未行辅助治疗,分别于确诊后4、5个月死于全身转移。结论：前列腺肉瘤首发症状大多为进行性排尿困难,PSA及DRE检查不能确诊前列腺肉瘤,术前需依靠磁共振成像、经直肠超声及前列腺穿刺活检共同确诊,免疫组化染色有助于其分类。该病预后差,治疗以根治性前列腺切除术为主,术后联合放、化疗等辅助治疗可提高患者生存率。     

前列腺肉瘤(附七例报告)

目的　提高前列腺肉瘤的诊治水平。　方法　 7例前列腺肉瘤患者 ,2例行全膀胱前列腺切除、去带盲升结肠可控膀胱术 ;1例行前列腺摘除术 ,术后辅以化疗 ;3例行放疗 ;1例仅行前列腺穿刺活检。　结果　 2例行全膀胱前列腺切除者 ,1例存活 5年至今 ,1例术后 9个月死于肿瘤肺转移 ;余 5例均在 13个月内死亡。　结论　早期诊断并行根治性切除术可提高前列腺肉瘤患者的生存率     

前列腺肉瘤(附3例报告)

目的报告3例前列腺肉瘤的病例,结合文献回顾分析其临床特点,探讨前列腺肉瘤的诊断和治疗。方法复习病案,分别为青年、中年和老年男性,病理分别为前列腺横纹肌肉瘤、平滑肌肉瘤和纤维肉瘤。PSA介于0．4ng/ml到1．5ng/ml之间。术前CT均诊断为前列腺恶性肿瘤,确诊则采用经直肠超声引导下的前列腺穿刺活检。本文3例前列腺肉瘤中,1例采用规律VAC化疗；1例术前给予VAC新辅助化疗后行前列腺根治切除术；术后继续辅助VAC化疗。结果1例前列腺恶性纤维组织肉瘤的患者放弃治疗,半年后死亡。1例前列腺横纹肌肉瘤后前列腺体积明显缩小,于确诊10个月后发现肝转移、肺转移而死亡。1例前列腺平滑肌肉瘤行“前列腺根治性切除术”,术前、术后均给予VAC方案化疗,术后5个月发现肿瘤复发,术后1年死亡。结论前列腺肉瘤患者生存率的提高有赖于早期诊断和根治性切除,而新型放疗和化疗的应用,有助于改善患者的预后。     

前列腺肉瘤1例报道并文献复习

目的探讨前列腺肉瘤患者的临床诊治特点及预后。方法回顾性分析1例,前列腺肉瘤患者的临床资料．结合文献进行讨论。结果该患者经根治性膀胱,前列腺切除后未进行辅助治疗,随访13年8个月至今仍健康生存。结论前列腺肉瘤少见,预后大都不佳,以手术为主的综合治疗是最佳治疗方式,早期诊断和根治性切除有治愈的可能。     

成人原发性前列腺肉瘤的临床病理特点及预后

目的探讨前列腺肉瘤的临床表现、影像学特点、病理特征、治疗方法和临床预后。 方法回顾分析1999年1月至2019年12月收治的12例前列腺肉瘤患者的临床资料，总结分析前列腺肉瘤的临床病理特点，治疗方式及预后。 结果12例患者均行超声引导下经直肠前列腺穿刺活检，病理结果为前列腺肉瘤，其中横纹肌肉瘤6例，平滑肌肉瘤3例，未分化肉瘤2例，癌肉瘤1例。2例行根治性膀胱前列腺切除术+回肠代膀胱术，5例行根治性前列腺切除术；3例行放化疗；1例仅行化疗，1例仅行前列腺穿刺活检。12例患者除1例仍在随访外均因肿瘤复发转移死亡，平均生存时间15个月（8～25个月）。 结论前列腺肉瘤恶性程度较高，预后差，超声引导下前列腺穿刺活检和MRI有助于明确诊断，确诊主要依靠病理检查，治疗方法以手术为主，辅以放化疗等综合治疗。     

前列腺肉瘤6例报告

目的 提高前列腺肉瘤的诊治水平。方法 1992～2000年收治前列腺肉瘤6例,平均年龄34.4岁。占同时期前列腺恶性肿瘤的5.04%。其中平滑肌肉瘤4例,横纹肌肉瘤2例。1例行前列腺膀胱根治性全切和尿流改道术,3例行前列腺根治性切除术,术前或术中辅以放疗和术后化疗3例,其中1例仅单纯前列腺全切手术治疗。另2例明确诊断未治。结果 手术患者4例中,2例分别随访48及26月元瘤存活至今,1例随访15月后失访,1例术后10月死于转移性肺癌,另2例均在4月内死亡。结论 早期诊断、完整彻底的肿瘤病灶切除手术和针对性辅助治疗的选择可明显提高患者的生存率。     

Treatment of intimal sarcoma of peripheral veins

IntroductionIntimal sarcoma is an extremely rare group of undifferentiated pleomorphic sarcoma arising from the intimal layer of vessels accounting for only 1% of all sarcomas, intimal sarcoma of large veins are even less common.Cases presentationWe present two cases of intima sarcoma, one originated form the basilar vein and the other from the cephalic vein, the first one was treated with surgery and postoperative chemotherapy followed by Radiotherapy (RT), the second case was treated with isolated limb perfusion followed by marginal resection and RT. Both patients progressed to the lungs in a short time, the first case was treated with metastasectomy of the lung and is without evidence of disease 7 months after surgery; the second case treated with isolated limb perfusion has stable disease.DiscussionIntimal sarcoma are very aggressive tumors, with a high metastatic potential, the two patients progressed to lung in a short time (2 months) after local treatment. Both cases exhibit good response to chemotherapy and metastasectomy with a disease – free period of 7 months.ConclusionWe propose that given the aggressive behavior of these tumors, they should be treated with chemoradiotherapy postoperative, either by systemic chemotherapy or isolated limb perfusion for the limp sparing surgery in this histology.     

Clear cell sarcoma of kidney in an adolescent and in young adults: a report of four cases with ultrastructural, immunohistochemical, and DNA flow cytometric analysis

Clear cell sarcoma of the kidney is a distinct, highly malignant pediatric neoplasm. Its occurrence in adults is extremely rare and the subject of isolated case reports. We present a series of four cases (three males and one female) identified in an adolescent and in young adults (16, 18, 20, and 25 years) with flank mass (three cases), hematuria (two cases), flank pain (two cases), and hypertension (one case). Three patients had stage III disease and one had stage I disease (National Wilms' Tumor Study staging system). All tumors had predominantly or exclusively the classic histology of a monotonous proliferation of uniform small round cells with evenly distributed fine chromatin, although focal microcyst formation (two cases) and spindled architecture (one case) (variant patterns) were also noted. Therapy in all cases consisted of surgery and chemotherapy with or without radiation. Follow-up data (29-202 months) showed distant metastases in all four cases, including the lung (four cases), bone (two cases), and the liver (two cases). Three patients died of disease at 29, 59, and 63 months (mean, 50.3 months), and one patient is alive with no evidence of disease at 202 months. Ultrastructural features included scattered primitive junctions, short and irregular cytoplasmic extensions, and scant to a moderate amount of mitochondria. Immunohistochemical study (three cases) showed immunoreactivity with vimentin (two cases) and no reaction with cytokeratin, epithelial membrane antigen, S-100 protein, or desmin. Flow cytometric analysis showed diploid DNA content in three primary tumors and tetraploidy in one metastatic tumor. The proliferative activity (S-phase fraction) was low to intermediate (mean, 9.8%). Our data suggest that clear cell sarcoma of the kidney in the young adult age group resembles its pediatric counterpart in ultrastructural and immunohistochemical characteristics, proclivity for skeletal and visceral metastasis, DNA diploid status with relatively low S-phase, and aggressive clinical course. Clear cell sarcoma of the kidney in adult patients, although rare, must be differentiated from sarcomatoid carcinoma, sarcomas, and round cell tumors because of its unique characteristics in comparison to other renal neoplasms.     

Primary lymph nodal Kaposi's sarcoma of the parotid gland

Two cases of Kaposi's sarcoma arising within intraparotid lymph nodes are presented. The tumor masses, clinically thought to be primary epithelial tumors of the parotid gland, were pathologically defined as Kaposi's sarcoma. No other evidence of this disease has been found elsewhere in either of the two patients studied. Immunologic studies performed in both patients demonstrated a depression of T-lymphocyte function and altered cell-mediated immunity in one. Search of the medical literature shows that these are the first two reported cases of Kaposi's sarcoma arising within lymph nodes of salivary glands.     

前列腺肉瘤7例

目的：提高前列腺肉瘤的诊治水平。方法：收治前列腺肉瘤7例,占同期前列腺恶性肿瘤的7.6％。2例行全膀胱前列腺切除、去带盲升结肠可控膀胱术;1例行前列腺切除术,术后辅以化疗;3例行放疗;1例仅行前列腺穿刺活检。结果：2例行全膀胱前列腺切除者中,1例生存5年,1例术后9个月死于肺转移瘤;其余患者均在13个月内死亡。结论：早期诊断并行根治性手术可提高患者的生存率。     

Surgical treatment of primary sarcoma of the lung.

OBJECTIVE: To study the results of surgical treatment of primary lung sarcoma. METHODS: Between 1982 and 1998, we performed 18 macroscopically complete resections for primary sarcomas of the lung. The records of all patients were reviewed, as were pathological slides. Presence of symptoms, tumour size (more or less than 5 cm), complete resection, TNM stage and histology grade were analyzed for predictors of survival. RESULTS: Patients comprised 11 women and seven men whose age ranged from 19 to 73 years (mean 50 years). Mean tumour diameter was 8.05 cm (range 2.5-15 cm) There were one grade 1, eight grade 2 and nine grade 3 tumours. Tumours in two patients were unresectable at first presentation, and another was of doubtful resectability according to computed tomography scan. These three patients received pre-operative chemotherapy, with a partial response in the two unresectable patients allowing macroscopically complete resection in both cases. We performed 12 lobectomies (extended to the chest wall in two cases and to the diaphragm in two cases) and six pneumonectomies (extended to the chest wall in one case and the superior vena cava in one case). Operative and 30 days post-operative mortality were nil. Resection margins were invaded in two cases. Six patients received post-operative chemo- or radiotherapy and three others underwent repeat resections for pulmonary sarcoma recurrence. No patients were lost to follow-up. Pulmonary sarcomas recurred in eight patients (44%) leading to death in five cases after a mean period of 17 months. Overall median survival was 48 months, and actuarial 5-year survival 43%. Only TNM stage correlated with significantly increased survival. CONCLUSION: As complete resection is the best therapeutic option for obtaining an acceptable survival rate in primary pulmonary sarcoma, pre-operative chemotherapy can be a useful adjunct in increasing the resectability of these tumours.