原发性附睾恶性肿瘤的诊断和治疗（附5例临床报告）

目的加深对原发性恶性附睾肿瘤的认识,积累诊疗经验。方法收集我院2004年1月-2009年12月经手术后病理证实为附睾恶性肿瘤的5例患者资料进行回顾性分析,并作临床随访。结果恶性小细胞肿瘤3例,恶性畸胎瘤1例,左附睾恶性淋巴瘤1例。其中3例恶性小细胞肿瘤行术后放疗。术后随访1例恶性淋巴瘤患者于术后2月因并发肾功能衰竭死亡,其余4例随访21月未见其他脏器及腹膜后淋巴结转移征象。结论附睾肿块多为良性病变,附睾恶性肿瘤属于少见病,一旦确诊为原发性附睾恶性肿瘤,均应行患侧高位睾丸附睾切除,加强对附睾恶性肿瘤的研究总结有助于提高诊疗效果。

The diagnosis and treatment of primary malignant tumor in epididymis:a report of 5 cases

Objective To improve the diagnosis and treatment of primary malignant tumor in epididymis.Methods Clinical date of 5 cases with primary tumor in epididymis were reviewed and discussed with reviewing literature.The pathologic examination revealed malignant small cell tumor of 3 cases,malignant teratoma of 1case and malignant lymphoma of 1 case.1 case received resection of epididymis and Orchidectomy was performed in 4 cases.Results 4 cases have been followed up for 21 months without detectable recurrence or metastasis.1 case of malignant lymphoma died after 2 months of operation because of renal function failure.Conclusion The difference of clinical characters between benign and malignant tumor of epididymis is not obvious.Combination of history,physical examination and radiological examination especially color doppler ultrasonography are needed for diagnosis.The origin of malignant tumor of epididymis is complicated pathologically.Examination of immunohistochemisty may be needed.Surgical resection is the treatment of choice.