Oncoplastic Approach to Giant Benign Breast Tumors Presenting as Unilateral Macromastia

Benign breast tumors attaining large size constitute an important cause of unilateral macromastia. Their usual treatment involves enucleation or excision with a margin based on pathology and waiting for spontaneous retraction of skin envelope. In very large tumors, this will leave the residual breast deflated and unaesthetic, with spontaneous skin retraction giving unpredictable results. Application of the principles of oncoplastic surgery are helpful in this situation. Here, we present two cases of benign giant tumors—a giant fibroadenoma and a giant lipoma—managed by reduction mammaplasty approach to restore the breast symmetry and aesthetics.     

Synchronous Testicular Seminoma and Adrenocortical Carcinoma: A Case Report

We report a rare case of synchronous testicular seminoma and adrenocortical carcinoma. A 57-year-old man had a left testicular seminoma (clinical stage 1MB) with metastases to the lung and paraaortic lymph node. A complete response was obtained after 3 courses of chemotherapy with single-agent carboplatin. However, a left adrenal tumor was detected 1 2 months later and demonstrated a tumor volume doubling time of 2.1 months. Chemotherapy with bleomycin, etoposide and cisplatin failed to stop the tumor growth. A laparoscopic adrenalectomy was performed and pathology revealed an adrenocortical carcinoma. The patient has been free of recurrence for 42 months postoperatively.     

大鼠一侧睾丸扭转对侧睾丸改变的实验研究

目的 :研究一侧睾丸扭转 (UTT)后对侧睾丸组织学及生精细胞凋亡的改变 ,以明确UTT后对侧睾丸是否存在损伤。　方法 :SD雄性大鼠 6 0只 ,随机分为实验组 (n =4 8)及对照组 (n =12 )。实验组采用Turner方法建立左侧睾丸扭转模型 ,于扭转后 6h处死 4只 ,其余 4 4只再分为扭转睾丸复位及切除组 ,分别于术后 1d、1周、4周处死7～ 8只 ,取睾丸组织进行组织学及生精细胞凋亡的检测。　结果 :UTT复位后对侧睾丸组织学发生明显改变 ,生精细胞凋亡指数明显高于对照组 (P <0 .0 5 )。扭转睾丸切除后对侧睾丸变化不明显。　结论 :UTT可引起对侧睾丸损伤 ,其机制可能与再灌注有关 ,扭转睾丸切除可防止或减轻对侧睾丸的损伤     

Long-term Results of Adjuvant Irradiation or Surveillance in Stage I Testicular Seminoma

Background : Excellent treatment results are obtained for stage I testicular seminoma treated with orchiectomy and prophylactic radiotherapy. In patients with stage I nonseminomatous testicular tumors, surveillance alone is successful, however, this treatment option for stage I testicular seminomas is controversial. There have been few reports of long-term follow-up of surveillance alone for patients with stage I testicular seminoma.
Methods : To assess the appropriateness of this treatment option, a retrospective survey of stage I testicular seminoma was undertaken. Twenty-seven patients who underwent prophylactic radiation therapy (RT group) and 41 patients followed only by surveillance (S group) after high orchiectomy were evaluated. Their follow-up consisted of frequent clinical examinations, abdominal CT scans, chest x-rays and serum tumor markers.
Results : In the RT group, with a median follow-up period of 15 years, 1 patient (3.6%) had a recurrence in the lung at 4 months after orchiectomy and died, but the remaining 26 are alive with no evidence of disease (NED). In the S group, with a median follow-up period of 7.3 years, 5 (12.2%) relapsed in the retroperitoneal lymph nodes, but all are alive with NED following chemotherapy. The remaining 36 are all alive without recurrence (follow-up period, 38 to 132 months). Although the relapse rate in the S group was relatively higher than in the RT group, there was no significant difference between the 2 groups.
Conclusion : If a frequent follow-up protocol is administered and followed by the patient, surveillance alone may be a recommended management for stage I testicular seminoma.     

Testicular Seminoma in Father and Son. Case Report of Testicular Malignancies Occurring in Closely Related Family Members

Father and son had testicular seminomas. Father had right and son had bilateral malignancies: this is the 5. report of testicular malignancies occurring in fathers and sons. A review is made also of the literature on testicular malignancies occurring in closely related family members (26 reports only).     

大鼠单侧睾丸损伤对对侧睾丸组织的影响及其机制的探讨

目的：研究大鼠单侧睾丸损伤后对侧睾丸组织变化及其发生机制。方法：选择SD雄性大鼠40只,随机分为4组：A组为对照组,B组为单侧睾丸挫伤组,c组为单侧睾丸裂伤组,D组为裂伤后腹腔注射环孢素A（cyclosporinA,CsA）组。分别于第2、4周观察大鼠后足垫反应（footpadreaction,FPR）,取对侧睾丸做苏木精一伊红（HE）染色和免疫组化检测CD4分子、CD8分子的表达。结果：注射睾丸抗原48h后,B、C组大鼠右足足垫较A、D组显著增厚（P〈0．01）,C组与B组差异亦有显著统计学意义（P〈0．05）,A组与D组差异无统计学意义（P〉0．05）。B、C组对侧睾丸组织学发生明显改变,A、D组改变不明显。B、C组中CU’T细胞平均光密度（oD）值高于CD。’T细胞（P〈0．05）,两种T细胞OD值均明显高于对照组（P〈0．01）,C组与B组比较,CD4＋T细胞OD值差异有统计学意义（P〈O．05）,CD4＋T细胞OD值差异无统计学意义（P〉0．05）。各组结果在第2、4周比较,差异均无统计学意义。结论：单侧睾丸损伤可引起对侧睾丸组织发生迟发型超敏反应（delayedtypehypersensitivity,DTH）,主要由CD4＋T细胞介导,且与睾丸损伤程度有关。CsA可抑制DTH的发生。     

Establishment and Characterization of a New Human Testicular Seminoma Cell Line, JKT-1

Background: A new human testicular cancer cell line (JKT-1) was established, successfully transplanted into nude mice, and has been maintained for over 2 years. We examined the biological characteristics of JKT-1 cells.
Methods: The original material for JKT-1 was derived from a primary lesion of a left testicular seminoma (pure, typical-type) from a 40-year-old male. The tumor tissue was minced and cultured according to the explant culture method. The cells grew as a monolayer with a doubling time of 28.5 hours.
Results: JKT-1 produced neither alpha-fetoprotein or β-human chorionic gonadotropin, but showed strong immunoreactivities for vimentin and placental alkaline phosphatase. A chromosomal analysis revealed a modal number of 66 with loss of the Y chromosome. Morphologically, JKT-1 cells have a pleomorphic polygonal shape, an increase in the nuclear/cytoplasm ratio, and poor development of organelle and desmosome-like cell-cell junctions. JKT-1 cells were subcutaneously transplanted into the backs of 6-week-old nude mice, and grew classical seminomatous tissue.
Conclusion: This report profiled a seminoma cell line established for both in vitro and in vivo experimental systems. Future studies are planned to investigate germ cells using this seminoma line.     

睾丸扭转误诊后导致男性不育及勃起功能障碍(英文)

睾丸扭转在25岁以下的男性中其发病率约为1/4 000,其高发人群为新生儿和进入青春期的青少年。睾丸扭转的误诊率为4%,非同期的双侧睾丸扭转被误诊的发病率没有报导。本文报道1例由于双侧睾丸扭转误诊后导致的睾丸功能衰竭、性腺功能低下及勃起功能障碍。患者在睾丸扭转10年后才因不育和勃起功能障碍就诊,精液分析检查为无精症,血清中的睾酮水平降低到去势的水平(0.14 nmol/L)。其不育为永久性,其勃起功能经睾酮替代和使用西地那非后得以恢复。     

男性乳房发育症

男性乳房发育症(gynecomastia,GYN),又称男性乳腺增生症或男子女性型乳房,是指男性乳腺组织异常增生、发育.Rohrich等报告GYN在男性群体的发生率为32%～65%[1],Colonna等报告15～40岁GYN发生率约为65%[2].Daniels和Ismail等报告GYN是男性乳房最常见的病变,可发生于任何年龄,发生在青春期前、年青人和中年人被认为是不正常的.Gunhan-Bilgen报告10年来收治的236例男性乳房疾病,GYN 206例,占87.3%[3].谌章庆和唐朝晖综合文献报道,新生儿GYN发病率50%以上,青春期约为39%,也有高达50%～70%的报告,老年发生率较高,一组老年男性尸检的结果为40%,另一报告在50～69岁的住院男性中高达72%[4].Ersoz等报道特发性GYN是青春期和青壮年GYN最常见的类型[5].     

双侧睾丸生精小管内精原细胞瘤的诊断和治疗(附1例报告及文献复习)

目的:探讨睾丸生精小管内精原细胞瘤的诊断和治疗。方法:应用睾丸组织活检和病理检查的方法诊断1例双侧睾丸生精小管内精原细胞瘤患者,附睾内获取精子行卵细胞胞质内单精子注射(ICSI),受孕成功后再行双侧睾丸局部放射治疗。结果:睾丸活检病理结果为双侧睾丸生精小管内精原细胞瘤,附睾内获取液中可见大量发育正常的精子,行ICSI失败1次,再次行ICSI,已成功受孕,行双侧睾丸局部60Co放射治疗,双侧睾丸未见肿物生长。结论:睾丸生精小管内精原细胞瘤是生殖细胞瘤的一种类型,无临床症状,多在睾丸活检时发现,早期治疗预后较好,临床医师和病理科医师应给予重视。     

男性乳腺增生

本文综述近年来男性乳腺增生症的病理学、发病机理、分类、诊断及治疗方面的研究进展 ,重点探讨了男性乳腺增生症与环境的关系 ,对临床工作有一定的指导作用。