共查询到18条相似文献,搜索用时 120 毫秒
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目的 探讨前列腺叶状肿瘤的分型、临床表现、病理特征、治疗方法及预后情况.方法 2006年10月收治前列腺交界性叶状肿瘤患者1例.患者32岁,因渐进性排尿困难2周、尿潴留1 d入院.直肠指诊示前列腺明显增大,质软、囊性感,表面光滑.血清PSA 20.62 ng/ml.B超及MRI显示前列腺右侧叶多囊性肿大结节,前列腺穿刺活检考虑为良性间叶源性肿瘤,分化欠成熟.结果硬膜外麻醉下行前列腺肿瘤剜除术,切除标本约40 g.病理报告为前列腺交界性叶状肿瘤,肿瘤由上皮和间质成分构成,间质细胞明显增生,细胞有异型性,可见核分裂象;上皮细胞增多,无明显异型性;免疫组化染色Vimentin强阳性,PSA和PAP阳性,SMA阴性.术后40 d患者肿瘤复发,遂行前列腺根治切除术.病理报告为前列腺低度恶性叶状肿瘤,未侵及被膜外,前列腺尿道切端可见肿瘤组织;细胞增生活跃.术后1个月行体外盆腔放射治疗.随访6个月患者生存良好,仍在随访中.结论前列腺叶状肿瘤由增生的上皮和间质成分组成,穿刺活检很难穿到增生的上皮成分而不能确诊;复发恶性度增高,前列腺根治性切除术是目前最可靠的治疗方法. 相似文献
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前列腺恶性分叶状肿瘤的临床特征(附2例报告并文献复习) 总被引:1,自引:0,他引:1
目的:探讨前列腺恶性叶状肿瘤的临床特征。方法:报告2例前列腺恶性分叶状肿瘤患者的临床资料,并进行文献复习。结果:2例完整切除肿瘤,体积分别为22 cm×16 cm×11 cm和16 cm×10 cm×8 cm,重量分别为500 g和400 g。例1在54个月后死于肺转移;例2术后15个月,排尿通畅,无异常表现。结论:前列腺恶性叶状肿瘤罕见,根据临床表现并结合MRI、CT等影像学检查,可作出临床诊断,确诊依靠病理表现。根治性前列腺切除术是目前主要的治疗方法,放射治疗有一定的临床价值。 相似文献
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《中华男科学杂志》2015,(4)
目的:探讨前列腺恶性间叶肿瘤(PMMT)的诊断方法、治疗手段及预后情况。方法:回顾性分析20例PMMT患者的临床资料,并对所有患者进行随访,结合文献就其诊治及预后进行讨论。结果:20例患者中,常规病理和免疫组化确诊7例为平滑肌肉瘤,5例为横纹肌肉瘤,3例为间质肉瘤,1例为软骨肉瘤,4例为未分型恶性间叶肿瘤。12例(12/20)行根治性前列腺切除术(其中3例同时行乙状结肠造瘘,1例同时行膀胱造瘘),2例(2/20)行盆腔肿块切除术(术前均动脉栓塞),1例(1/20)行全盆器官切除术,1例(1/20)行盆腔淋巴结活检+结肠造瘘术,4例(4/20)因术前影像提示肺、盆腔、骨骼等转移而行保守治疗。本组中9例(9/20)治疗后3个月内肿瘤全身转移而死亡;3例(3/20)分别为术后6、7及14个月死亡;3例(3/20)分别带瘤存活5、11、12个月;2例(2/20)无瘤存活至今已12、24个月,均为术后行周期性化疗者;3例(3/20)失访。结论:前列腺恶性间叶肿瘤恶性程度高、进展快,经直肠超声引导下穿刺活检仍是确诊PMMT的主要手段,临床分期是影响预后的重要因素,早期诊断和以根治性前列腺切除为主的综合治疗可以显著提高患者生存率。 相似文献
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目的探讨前列腺导管腺癌的临床、病理特征及治疗方法。方法1例反复血精5个月,血尿4个月的患者直肠指诊示:前列腺右侧可及直径约1cm质软肿物。血清前列腺特异抗原(PSA)0.7ng/ml。前列腺穿刺活检提示前列腺腺癌。患者行根治性前列腺切除术。结果病理报告:前列腺右叶大导管腺癌,向外浸润右侧精囊,Gleason分级5/4(Sum=9),pT3b;免疫组化染色PSA(+),前列腺酸性磷酸酶(PAP)(++),雄激素受体(AR)(-)。患者术后恢复良好,血精、血尿消失,随访7年仍存活。结论前列腺导管腺癌是前列腺癌罕见的亚型,难于早期诊断,确诊主要依靠病理和免疫组化检查,治疗方法可采用根治性前列腺切除术。 相似文献
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目的:探讨前列腺恶性纤维组织细胞瘤(MFH)的临床特点及诊断治疗方案,提高对该疾病的认识。方法:报告1例22岁青年男性前列腺MFH病例,并复习相关文献,探讨该疾病特点、诊治方法。结果:患者行前列腺穿刺活检术,病理回报为多形性恶性纤维组织细胞瘤,行放化疗+靶向治疗。放疗后14个月因肿瘤复发、转移死亡。结论:MFH主要表现为局部压迫或梗阻造成相应临床症状,恶性程度高,进展快,生存时间短,易远处转移。根治性手术切除是主要治疗手段,术后再辅以放射治疗、化疗等综合治疗等以提高存活率。 相似文献
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IntroductionPhyllodes tumors (PTs) of the breast are extremely rare accounting for less than 1% of all breast tumors globally. Case records at the Trinidad and Tobago Cancer Registry show that only 0.003% of the reported breast cancer cases between 1995 and 2009 were PTs.Presentation of the caseWe report a 45-year-old woman who presented with swelling of the left breast. Ultrasound, mammogram and computed tomography imaging confirmed the presence of a mass in the right upper inner quadrant of the left breast. A biopsy revealed features supportive of a benign phyllodes tumor. A wide local excision was performed with the removal of a 19 × 11 × 10 cm mass. Histopathological analysis revealed features consistent with malignant phyllodes tumor. A complete mastectomy of the left breast was subsequently performed. Follow up over a 5-year period did not reveal any evidence of local recurrence or residual disease. To the best of our knowledge, this is the first case report of a malignant PT from the Caribbean and Latin America.DiscussionPhyllodes tumors are classified as benign, borderline, or malignant based on histologic features including presence of a clear margin, cellularity, stromal overgrowth, tumor necrosis and mitotic index. The clinical challenge is to assess the risk of local tumor and metastatic recurrence in the context of fluid classifications.ConclusionOur case management approach shows that for patients with malignant PT, a thorough preoperative workup regimen followed by appropriate surgical intervention can result in a desirable prognosis. 相似文献
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Malignant phyllodes tumor of the prostate 总被引:5,自引:0,他引:5
Shinya Yamamoto Takaaki Ito Makoto Miki Hiromi Serizawa Suguru Maekawa and Masakuni Furusato 《International journal of urology》2000,7(10):378-381
We report a case of malignant phyllodes tumor of the prostate which is the eleventh reported case in the world. Phyllodes tumor of the prostate is extremely rare and histologically resembles mammary phyllodes tumor. Phyllodes tumor of the prostate is classified into benign, borderline and malignant, but health professionals should carefully follow up the borderline cases in case they take a malignant clinical course. This case was the first to be treated by pre- and postoperative radiation therapy. Although the patient had a slight response to radiation therapy, he eventually developed metastasis. Because malignant phyllodes tumor of the prostate is a very aggressive tumor, people with the condition should undergo systemic chemotherapy as adjuvant therapy. 相似文献
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TAU-AN CHEN JUNG-MAO CHOU GUANG-HUAN SUN HERNG-SHENG LEE 《International journal of urology》2005,12(11):1007-1009
We report the case of a 47-year-old male patient who suffered from a malignant phyllodes tumor of the prostate with invasion to the rectum and urinary bladder. The local recurrence at the left scrotum was identified 6 years after radical cystoprostatectomy. Another 2 years after radical orchiectomy showed no evidence of secondary local recurrence or distant metastasis. Histopathologically, both primary and recurrent tumors showed an admixture of stromal and glandular components. However, while extensive squamous metaplasia was identified in the primary tumor, the recurrent tumor had only focal and mild squamous metaplasia. No dependable prognostic factor has been found to date. Here, we describe the morphological features and immunohistochemical presentations of malignant phyllodes tumor of the prostate and review the literature. 相似文献
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Case report: Malignant phyllodes tumor of prostate 总被引:2,自引:0,他引:2
Malignant phyllodes tumor of prostate is described in a 78 year old man. He had symptoms of prostatism since six months before developing acute urinary retention, which was relieved by suprapubic cystostomy. Transabdominal ultrasonography showed a few hypoechoic areas in a 120 gm prostate. Serum prostate specific antigen was 2.7 ng/ml. Transrectal trucut biopsy was inconclusive. With a diagnosis of benign hyperplasia of prostate. Transvesical prostatectomy was performed. Postoperative biopsy showed phyllodes tumor of the prostate with metastastic deposits in the anterior abdominal wall. He received chemotherapy with Vincristine, Mitomycin C, Adriamycin and Cisplatin every 21st day for six cycles in addition to orchiectomy. Routine follow up by transabdominal ultrasound at ten months showed space occupying lesions in the liver. Patient succumbed to his disease a few days later. 相似文献
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IntroductionPhyllodes tumours are uncommon fibroepithelial lesions that typically grow up to 4 cm in size but 10 cm tumours known as giant phyllodes tumours have been described. We present a case report of a 20 cm benign phyllodes tumour and a literature review.Presentation of caseA 54 years old lady with an enlarging left breast mass measuring 20 cm of 6 months duration presented to our outpatient breast clinic. She also had an incidental right parotid lump. Core biopsy of the left breast mass returned as a cellular fibroepithelial lesion. A mastectomy and axillary lymph node sampling were done and skin cover was obtained from a split skin graft from the thigh. Final histology returned as a benign phyllodes tumour. Her post-operative recovery was uneventful.DiscussionPhyllodes tumours are suspected in middle age women with rapidly enlarging painless breast masses. Though there are some suggestive features on ultrasound and MRI, the key to diagnosis is still histopathology. However, a pre-operative diagnosis may not always be possible as the interpretation of stromal cellularity and degree of atypia needed to differentiate cellular fibroadenoma from a phyllodes tumour is subjective. When a phyllodes tumour is suspected, adequate margins should be taken for optimal outcome.ConclusionSuccessful management of phyllodes tumour involves obtaining a pre-operative diagnosis via a core biopsy when possible and planning for adequate margins. 相似文献
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Solitary fibrous tumor in the mesentery is rare. We report a case of a malignant solitary fibrous tumor in the appendical mesentery of 6-year-old boy. Computed tomography and ultrasound of the abdomen demonstrated a well-defined solid mass, 4.0 cm in diameter, in the lower right abdomen. At laparotomy, an encapsulated tumor was observed in the appendical mesentery and was easily separated from the appendix. Immunohistochemistry stain showed that the spindle-shaped cells were positive for CD34 and neuron-specific enolase. DOG-1, CD117, desmin, S-100 protein, and SMA were negative. The sequence of KIT and platelet-derived growth factor receptor α was presented with wild type, no mutation. The patient received the reoperation 5 months postoperation. Despite these treatments, the relapsed tumor rapidly and markedly enlarged. The patient died of recurrent tumor with liver dissemination 7 months after reoperation. 相似文献
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目的 提高对肾脏、前列腺恶性纤维组织细胞瘤(malignant fibrous histiocytoma,MFH)的认识。方法 MFH患者3例,均为男性。2例原发性肾脏MFH者年龄为69、73岁,临床表现为低热或腰部疼痛、消瘦,B超及CT示肾脏实性占位性病变,分别为8.0cm×7.0cm、7.4cm×6.6cm。1例原发性前列腺MFH患者年龄39岁,临床表现为排便困难,B超及CT示前列腺内囊实性占位性病变18.1cm×14.5cm。结果 3例分别行根治性左肾切除术、左肾切除加局部浸润组织切除、膀胱前列腺切除术加直肠切除术加乙状结肠造瘘术。首次手术均完整切除肿瘤。光镜下见肿瘤细胞常排列成席纹状,形态多样,主要由梭形的纤维母细胞样细胞和圆形、卵圆形组织细胞样细胞组成,并有不等量的多形性巨细胞及炎细胞。免疫组化染色示vimentin、-AAT、α1—ACT、CD68(+),EMA、Desmin、S-100(-)。2例肾脏MFH患者分别于首次术后16、21个月因纵隔广泛转移或局部复发伴腹腔转移死亡,前列腺MFH患者术后3个月因肿瘤肺转移死亡。结论 原发性肾脏和前列腺MFH是一类罕见的、高度恶性的肿瘤,预后差,确诊需依赖组织病理学及免疫组织化学检查,早期诊断及原发病灶的彻底切除是治疗的关键。 相似文献
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肾恶性横纹肌样瘤一例报告及文献复习 总被引:1,自引:0,他引:1
目的探讨肾恶性横纹肌样瘤(MRTK)的临床特征及诊治方法。方法总结1例MRTK患者的临床资料。女性,18岁,临床表现为右腰部疼痛1个月。B超示右肾中高回声占位,边界清楚,周围有血管绕行,其内血流信号丰富。CT示右肾占位9.5cm×6.0cm,不均匀强化,腹主动脉旁可见软组织肿块影。检索Pubmed和CBM数据库相关文献进行复习。结果患者行右肾切除术,腹主动脉、下腔静脉周围可见成团软组织块,与血管粘连紧密无法分离.取活检。病理报告:肿瘤由小圆形细胞构成,富含胞质,部分嗜酸性,部分细胞呈空泡状。免疫组化:CK(+),Vimentin(+)。病理诊断右肾MRTK。患者术后4个月死于肿瘤转移。结论MRTK临床罕见,生物学行为进展快、浸润性强,诊断主要依据病理,对于发病年龄低及临床分期高的肾肿瘤患者应考虑MRTK的可能,治疗以手术为主,预后差。 相似文献