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。

Prostate Sarcoma: a Report of 14 Cases

Objective: To discuss the diagnosis and effective treatment of prostate sarcoma.Methods: We analysed the clinical materials of fourteen patients with prostate sarcoma treated in our hospital from Jan.1991 to Jun.2004.Results: Prostate sarcoma accounted for(3.21)% of all the prostatic malignant tumors treated in our hospital during that period.The average age was(39.5) years old(ranging from 17 to 62).Twelve cases came to our hospital because of dysuria.Large soft prostate tumors were found in all the patients in physical examination.The serum AKP,ACP and PSA levels were normal in all the 10 patients who had received the test.Pathological test revealed: 7 cases eiomyosarcoma,1 case rhabdomyosarcoma,4 cases fibrosarcoma,2 cases spindle cell sarcoma.Different kinds of prostate sarcoma each his its own immuno-histochemical staining features.Two cases were at Ghavimi Stage I,5 at Stage II,3 at Stage III,and 4 at Stage IV.All the patients received surgery,chemotherapy and/or radiotherapy.One case failed to be followed up,11 died 2~12 months after diagnosis.Two patients are still alive,1 for 18 months without recurrence,and the other for through with relapse.Conclusion: Dysuria is always the first symptom of prostate sarcoma.DRE test may suggest prostate sarcoma but needle biopsy contributes to a definite diagnosis.The immuno-histochemical dyeing helps to differentiate the disease.The prognosis of prostate sarcoma is very poor and the main treatment is surgery followed by chemotherapy and/or radiotherapy.