前列腺肉瘤(附3例报告)

目的报告3例前列腺肉瘤的病例,结合文献回顾分析其临床特点,探讨前列腺肉瘤的诊断和治疗。方法复习病案,分别为青年、中年和老年男性,病理分别为前列腺横纹肌肉瘤、平滑肌肉瘤和纤维肉瘤。PSA介于0．4ng/ml到1．5ng/ml之间。术前CT均诊断为前列腺恶性肿瘤,确诊则采用经直肠超声引导下的前列腺穿刺活检。本文3例前列腺肉瘤中,1例采用规律VAC化疗；1例术前给予VAC新辅助化疗后行前列腺根治切除术；术后继续辅助VAC化疗。结果1例前列腺恶性纤维组织肉瘤的患者放弃治疗,半年后死亡。1例前列腺横纹肌肉瘤后前列腺体积明显缩小,于确诊10个月后发现肝转移、肺转移而死亡。1例前列腺平滑肌肉瘤行“前列腺根治性切除术”,术前、术后均给予VAC方案化疗,术后5个月发现肿瘤复发,术后1年死亡。结论前列腺肉瘤患者生存率的提高有赖于早期诊断和根治性切除,而新型放疗和化疗的应用,有助于改善患者的预后。

Sarcoma of the prostate (Report of 3 cases)

Objective Analyzed and reviewed the clinical characteristics of prostate sarcoma. Methods The histological subtypes were rhabdomyosarcoma, leimyosarcoma and fibrosarcoma, respectively. The PSA level of these three cases are between 0.4ng/ml-1.5ng/ml. The CT scanning detected the signs of prostate malignancy preoperatively and transrectal ultrasound guided core biopsy establisbed the final diagnoses. One case was only administered with chemotherapy and another case was given combined therapy with both preoperative VAC chemotherapy, radical prostatectomy and postoperative VAC chemotherapy. Results One patient with fibrosarcoma died 6 monthes after diagnosis without any treatment. One patient with rhabdomyosarcoma was administered with VAC chemotherapy. The mass of tumor decreased 5 monthes later, but died 10 monthes later because of lung and liver metastases. One case of leimyosarcoma was performed radical prostatectomy with adjunctive VAC chemotherapy. However, the patient died one year later with reccurent tumor. Conclusion The improvement of the survival depends on the early diagnosis and radical resection of the prostate and surrounding tissues. The application of new radiotherapy and chemotherapy is conducive to the improvement of the prognosis.