睾丸网腺癌6例报告

目的:探讨睾丸网腺癌的发病和临床特点,以做到早诊断、早治疗.方法:报告6例睾丸网腺癌患者的临床资料.6例均为左侧发病,术前均诊断为左侧附睾和睾丸炎,并继发性睾丸鞘膜积液;拟行患侧附睾切除加鞘膜翻转术.术中发现左睾丸质硬有肿物并侵及附睾,遂行睾丸、附睾切除术.结果:术后病理检查诊断为睾丸网腺癌侵及睾丸和附睾;6例术后均获随访.结论:睾丸网腺癌在临床表现独特,根治性睾丸切除辅以根治性腹膜后淋巴结清扫术效果满意,放疗和化疗效果欠佳.     

睾丸网腺癌(1例报告并文献复习)

目的了解睾丸网腺癌的发病和临床特点，提高其早期诊断和治疗水平。方法分析1例睾丸网腺癌患者的临床资料，并结合文献对睾丸网腺癌的临床病理特点、早期诊断和治疗进行讨论。结果术前诊断为左睾丸鞘膜积液、左睾丸肿瘤待排，遂行左高位睾丸切除术，术后病理检查诊断为睾丸网腺癌。免疫组化：AFP（-），PLAP（-），CK（＋），CD30（-），CK20（＋）。术后CT示肝内多发转移瘤、左肾和左肾上腺转移改变。结论睾丸网腺癌是原发于睾丸网纵膈的恶性肿瘤，极为罕见，其临床表现独特，基本治疗是根治性睾丸切除术辅以根治性腹膜后淋巴结清扫术，放疗和化疗效果欠佳。该病预后差，文献报道5年生存率仅为13％。     

原发性附睾腺癌的诊断与治疗（附2例报告并文献复习）

目的：提高对原发性附睾腺癌的认识。方法：回顾性分析2例原发性附睾腺癌患者的临床资料：2例肿瘤均位于右侧，累及附睾体部、尾部及精索，其中1例发现有远处转移。1例行右侧精索、附睾、睾丸高位切除术，另1例行’右睾丸、附睾、精索根治性切除术并腹膜后淋巴结清扫术。结果11例病理检查报告为右侧附睾乳头状腺癌伴慢性炎症，随访至今未见转移及其他异常；另1例报告为右附睾腺癌，部分累及睾丸，术后5个月死于多器官功能衰竭。结论：原发性附睾腺癌早期确诊困难，病程进展快，预后差。手术是首选治疗手段，放疗和化疗尚缺乏临床经验。     

睾丸鞘膜纤维性假瘤（附5例报告）

目的：提高对睾丸鞘膜纤维性假瘤的认识及诊疗水平.方法：回顾性分析1994年3月～2009年6月收治的5例睾丸鞘膜纤维性假瘤的临床资料;5例患者均以发现阴囊内肿块而入院,体检发现睾丸和附睾旁数个大小不一的类圆形结节,结节质韧,无压痛,活动度好,无粘连;B超发现结节为实性低回声光团、无明显血流信号;5例均行手术治疗.结果：1例行睾丸、附睾及多发性结节切除术,4例行保留睾丸、附睾的多发性结节和睾丸鞘膜切除术,1例术中快速冷冻切片为炎性假瘤,术后病理结果均为睾丸鞘膜多发性纤维性假瘤,随访1～5年无复发.结论：睾丸鞘膜纤维性假瘤是一种少见的阴囊部位良性肿瘤样病变,提高认识后诊断不难,治疗上行保留睾丸、附睾的多发性结节和睾丸鞘膜切除术即可,无需行睾丸附睾切除术.     

睾丸鞘膜恶性间皮瘤1例并文献复习

目的：分析睾丸鞘膜恶性间皮瘤并总结其临床特点、诊断及治疗。方法：报告1例睾丸鞘膜恶性间皮瘤的I艋床表现、治疗经过、病理结果,并回顾文献对该病的相关报道。结果：患者经手术治疗后出院,术后病理提示左睾丸鞘膜恶性间皮瘤,肿瘤未侵及睾丸。精索切缘未见肿瘤残余。免疫组化标记：CK5／6（＋）,Vimentin（＋）,EMA（＋）,CK8（＋）。术后密切随访中。结论：睾丸鞘膜恶性间皮瘤是一种罕见的泌尿生殖系恶性肿瘤,诊断主要依据病理,治疗以根治性睾丸切除术为一线治疗方式,预后多不良。该病的发生可能与石棉等多种因素相关。     

睾丸网腺癌1例报告

睾丸网腺癌是一种罕见的睾丸恶性肿瘤, 侵袭性强、预后差。因缺乏特异性肿瘤标志物, 影像学检查缺少特征性表现, 故早期诊断睾丸网腺癌困难, 确诊依靠病理和免疫组化染色检查。本病目前尚无系统的治疗方案, 根治性睾丸切除术是首选治疗方式。本文报道1例66岁睾丸网腺癌患者, 行右侧睾丸高位切除术。术后患者拒绝放化疗。术后8个月出现肺、肝和腹膜后淋巴结转移, 术后15个月死于全身多发转移。     

附睾及睾丸鞘膜血管平滑肌瘤（附1例报告及文献复习）

目的 提高对附睾及睾丸鞘膜血管平滑肌瘤的认知水平。方法 回顾性复习了1例临床罕见的附睾及睾丸鞘膜血管平滑肌瘤的诊治资料。结果 手术切除肿瘤，术后病理证实为血管平滑肌瘤。随访至今，无复发。结论 附睾及睾丸鞘膜血管平滑肌瘤的术前诊断较困难，确诊需经病理学检查，手术切除是最佳的治疗方法。     

睾丸鞘膜纤维假瘤1例报告

回顾性分析1例睾丸鞘膜纤维假瘤患者的临床及病理资料。经阴囊切口探查为睾丸鞘膜光滑的肿块,术中冰冻提示良性肿瘤,故行肿瘤及部分睾丸鞘膜切除。术后病理报告为睾丸鞘膜纤维假瘤,术后6个月复查未见肿瘤复发及转移。睾丸鞘膜纤维假瘤发病率低,但属于良性肿瘤样病变,可行保留睾丸的肿瘤切除术,若术中无法明确良恶性,需行根治性睾丸切除术。     

睾丸鞘膜恶性间皮瘤7例临床分析

目的探讨睾丸鞘膜恶性间皮瘤的临床表现、诊断和预后。方法回顾性分析2010年1月到2022年10月在中山大学肿瘤防治中心泌尿外科诊治的7例睾丸鞘膜恶性间皮瘤患者的临床和病理学资料。7例患者初诊年龄[M(IQR)]为49(23)岁(范围:27～64岁)。主要临床表现有阴囊肿大7例, 鞘膜积液2例。3例患者发生腹膜后淋巴结转移, 2例患者合并远处转移(肺, 肺门、纵隔及锁骨上淋巴结)。结果 3例患者初治即接受患侧根治性睾丸切除术, 2例在外院接受了经阴囊睾丸切除术, 2例因诊断为鞘膜积液在外院先接受了睾丸鞘膜切除术, 病理学检查结果证实后在中山大学肿瘤防治中心泌尿外科接受了根治性睾丸切除术。常见的肿瘤标志物均未明显升高。2例患者PD-L1免疫组化染色呈阳性。1例患者接受了术后辅助化疗, 2例患者在肿瘤复发后接受了一线化疗。使用的化疗方案包括顺铂+培美曲塞方案等。随访截至2022年10月, 3例复发, 其中2例因肿瘤进展死亡。中位总体生存期35个月(范围:4～87个月), 中位无复发生存期6个月(范围:2～87个月)。结论睾丸鞘膜恶性间皮瘤早期可积极行根治性睾丸切除术, 术后密切随访。转移性肿...     

原发性附睾肿瘤的诊断与治疗(附35例报告)

目的:探讨原发性附睾肿瘤的诊断及治疗方法。方法:回顾性分析本院35例原发性附睾肿瘤患者的临床资料。行肿瘤切除术10例,患侧附睾切除23例,患侧睾丸附睾切除加腹股沟淋巴结清扫1例,患侧根治性睾丸切除加二期腹膜后淋巴结清扫术1例。附睾恶性纤维组织细胞瘤1例术后辅以放疗及化疗。结果:术后病理诊断良性肿瘤33例,其中腺瘤样瘤21例,平滑肌瘤7例,纤维瘤4例,乳头状囊腺瘤1例;恶性肿瘤2例,附睾恶性纤维组织细胞瘤1例,附睾腺癌1例。35例术后随访10个月至6年,未见复发、转移及死亡病例。结论:原发性附睾肿瘤术前明确诊断困难,对于高度怀疑附睾肿瘤的患者应首选手术探查,良性者可行肿瘤或附睾切除,恶性者行根治性睾丸切除加腹膜后淋巴结清扫术。     

Primary adenocarcinoma of the rete testis

We report a case of adenocarcinoma of the rete testis in a 44-year-old man, presented intially with a hydrocele and later with signs of infection in the affected hemiscrotum. Multiple focal lesions within the testis appeared 6 months later in ultrasounds. After high inguinal orchiectomy, histology revealed a primary adenocarcinoma of the rete testis. Adenocarcinoma of the rete testis is a rare a highly malignant tumour originating in the mediastinum of the testis. Slightly over 40 cases have been reported in the literature. The treatment of choice is radical orchiectomy. Prognosis is poor; as mainly as 40% of patients die within the first year of diagnosis.     

Adenocarcinoma of rete testis

We report a case of adenocarcinoma of rete testis in 64-year-old man. His first diagnosis was hydrocele of left testis, but aspiration cytology showed malignancy. The patient underwent left orchiectomy. The pathological diagnosis was adenocarcinoma of the rete testis. The cancer was suspected to be arising from the duct of rete testis on the histological examination, and no other malignancy was found elsewhere in his body. However, he died at 10 months after the operation for lung metastasis. Adenocarcinoma of rete testis is one of the rarest malignancies. Only 25 cases have been reported since the first case was described by Feek and Hunter in 1945. This is the twenty-sixth case in the literature.     

Cystadenocarcinoma of the rete testis

We report a rare case of primary adenocarcinoma of the rete testis. The stage A lesion was managed successfully with orchiectomy and retroperitoneal lymph node dissection. The histopathological features, treatment and prognosis of this unusual malignancy are reviewed.     

Adenocarcinoma of the rete testis. A case report

Adenocarcinoma of the rete testis is a rare malignant tumor with a poor prognosis. About 60 cases of this adenocarcinoma have been reported in the literature. The diagnosis is often difficult and made incidentally. Herein, we report a case of adenocarcinoma of the rete testis and review the literature. Our patient was an 80-year-old man who presented with painless scrotal swelling for 2 years. Physical examination revealed an enlarged, hard mass of the left scrotum. The serum markers alpha-fetoprotein (AFP), beta-human chorionic gonadotropin (beta-HCG), and carcinoembryonic antigen (CEA) were negative. Magnetic resonance imaging (MRI) showed a left hydrocele with central necrosis of the testis. After 4 months, the patient presented with appetite loss, general fatigue, and pain in the left scrotum. Positron emission tomography (PET) was performed in another hospital, and the patient was referred for a left testicular tumor, multiple lung metastases, and para-aorta lymph node metastasis. The patient underwent left high inguinal orchiectomy. Pathological examination revealed a hard whitish mass around the testis involving the epididymis and tunica vaginalis and spreading under the subcutaneous tissue. Histological examination revealed adenocarcinoma in the hilum of the testis, which extended to the subcutaneous tissue but not to the surface of the scrotum. The tunica albuginea was intact, and no invasion of carcinoma in the testis was seen. After the histological diagnosis of adenocarcinoma of the rete testis was confirmed, computed tomography (CT) was performed and showed multiple pulmonary nodules and para-aortica lymph node swelling of 3 cm diameter. Because the patient did not wish to receive chemotherapy or other aggressive treatment, he has been followed-up with palliative care since his diagnosis. Although local recurrence has occurred 4 months later, he is still alive for 8 months since his diagnosis.     

Rete testis adenocarcinoma recurring in the inguinal lymph nodes. A case report

Adenocarcinoma of the rete testis is a rare neoplasm with 41 reported cases in the literature till 1994. In most of the reported cases, the neoplasm presents as a scrotal mass with diffuse enlargement. The aetiology is unknown and the clinical course of the tumour is not very well defined. In six of the reported cases metastatic spread of the tumour to inguinal lymph nodes was demonstrated in the follow-up. We report herein a distinctive case of rete testis adenocarcinoma presenting as an isolated inguinal recurrence one year after radical orchiectomy.     

Papillary adenocarcinoma of rete testis. Autopsy findings, histochemistry, immunohistochemistry, ultrastructure, and clinical correlations

Adenocarcinoma of the rete testis is a rare neoplasm that usually occurs in men after the age of 60 and carries a variable prognosis. We report an occurrence of this tumor in a 91-year-old man who had been treated for 2 years for an hydrocele. At the time of diagnosis, metastases were not evident; and the patient was treated with local radiotherapy. The diagnosis of papillary adenocarcinoma of the rete testis was made on the basis of: (a) a transition from normal rete testis to atypical and neoplastic rete epithelium; (b) exclusion of primary germinal and nongerminal testicular tumors and spread from distant sources; and (c) electron-microscopic findings, histochemical and immunological studies, and autopsy findings supporting the diagnosis. This is the first reported case of adenocarcinoma of the rete testis that includes documentation of the tumor's metastatic pattern.     

Outcome of different post‐orchiectomy management for stage I seminoma: Japanese multi‐institutional study including 425 patients

Objectives: To clarify the contemporary clinical outcome of stage I seminoma and to provide information on treatment options to patients. Methods: A retrospective analysis of 425 patients who underwent orchiectomy for stage I seminoma between 1985 and 2006 at 25 hospitals in Japan. Relapse‐free survival rates were calculated using the Kaplan–Meier method and clinicopathological factors associated with relapse were examined by univariate and multivariate analyses using the Cox proportional hazards model. Results: A total of 30 out of 425 patients had relapsed. Relapse‐free survival rates at 10 years were 79, 94 and 94% in the surveillance, chemotherapy and radiotherapy groups, respectively. Post‐orchiectomy management and rete testis invasion were identified as independent predictive factors associated with relapse. Rete testis invasion remained to be an independent predictive factor, even if the cases with relapses in the contralateral testis were censored. Only one patient, who relapsed after adjuvant radiotherapy, died of the disease. Overall survival at 10 years was 100, 100 and 99% in the surveillance, chemotherapy and radiotherapy groups, respectively. More than half of the patients were lost to follow up within 5 years. Conclusions: The outcome of Japanese patients with stage I seminoma is similar to previously published Western reports. Surveillance policy is becoming a popular option in Japan, although the relapse rate in patients opting for surveillance policy is higher than those opting for adjuvant chemotherapy or radiotherapy. Rete testis invasion is an independent predictive factor associated with relapse regardless of the post‐orchiectomy management. Long‐term follow up is mandatory for detection of late relapse.     

Adenocarcinoma of the rete testis. Review of the literature apropos of a new case

The authors report the case of a 66 year old man with a Boden stage I adenocarcinoma of the rete testis treated by orchiectomy and adjuvant chemotherapy. Lung metastases developed 46 months later and were responsible for death despite further chemotherapy. Adenocarcinoma of the rete testis is an exceptional tumour, as only 23 cases satisfying the criteria defined by Feek and Hunter have been reported in the literature. The prognosis is poor even in the apparently localized forms (5 year survival less than 25%) and local recurrences and lung and/or hepatic metastases are frequent. Radiotherapy and chemotherapy appear to have little value.