儿童睾丸良性肿瘤临床分析

目的总结儿童睾丸良性肿瘤的临床病例资料，探讨诊断、治疗及预后。方法回顾性分析2000年8月~2013年8月我院收
治的37例小儿睾丸良性肿瘤的临床病例资料。患者年龄3个月~12岁，中位年龄14个月，2岁及以下21例。左侧18例，右侧15
例，双侧4例，后者均为肾上腺睾丸残基瘤。其中35例以睾丸肿块就诊，1例睾丸残基瘤体检发现，1例睾丸成熟畸胎瘤因“会阴
坠痛”就诊，均经超声或CT检查，33例行瘤标检测。37 例睾丸良性肿瘤中，其中25例行睾丸根治性切除术，12例行保留睾丸手
术。结果37例患者随访3~107个月，中位时间为46个月。所有受访患者未见肿瘤复发转移或者残留睾丸萎缩等并发症，并有
3例自然生育。结论良性肿瘤在小儿睾丸肿瘤占有较高比例，应重视良性肿瘤的术前诊断和治疗, 尽量保留睾丸。术前超声或
者CT结合肿瘤标志物（AFP等）可以作为判断睾丸肿瘤性质的重要指标，对于睾丸良性肿瘤者可采取保留睾丸组织的手术。

Clinical analysis of pediatric testicular benign tumors

Objective To explore the diagnosis, treatment and prognosis of testicular benign tumors in children. Methods The
clinical data of 37 boys (aged between 3 months to 12 years) with testicular tumors treated in our center between August 2000
and August 2013 were retrospectively analyzed. The median age was 14 months and 21 boys were less than 2 years old. The
tumors were on the left side in 18 cases, on the right side in 15 cases, and on both sides in 4 cases (adrenal residue testis tumor).
Thirty-five patients presented with painless scrotal mass; in the other two cases, testicular residue tumor was found in routine
medical examination in one case and testicular mature teratoma was found due to perineal pain in the other; both of the boys
underwent ultrasound or CT examination. Thirty-three boys had tumor marker detection. Of the 37 boys with benign
testicular tumors, 25 underwent radical inguinal orchiectomy and 12 had testis-sparing surgery. Results The boys were
followed up for 3-107 months (median 46 months). No patients were found to have tumor recurrence, metastasis or such
complications as testicular atrophy; 3 boys had natural fertility later in adutthood. Conclusions A high proportion of testicular
tumors in children are benign. Preoperative ultrasound or CT combined with detection of tumor markers such as serum AFP
can be important in the diagnosis of pediatric testicular tumors, for which testis-sparing surgery should be considered.