成人前列腺肉瘤6例临床分析

目的:探讨前列腺肉瘤的诊断、治疗及预后因素。方法:本组6例患者,年龄18~44岁,中位年龄31岁。病程3~12个月,中位病程7个月。Ⅱ期2例,Ⅲ期3例,Ⅳ期1例。6例中,5例行手术治疗+放疗和(或)化疗,1例行单纯膀胱造瘘术。结果:病理诊断:平滑肌肉瘤3例,横纹肌肉瘤2例,恶性神经鞘瘤1例。免疫组化结果显示6例vim entin均为阳性,PSA和PAP均为阴性。平滑肌肉瘤和横纹肌肉瘤肌动蛋白(HHF35)为阳性,恶性神经鞘瘤S-100和溶解酶为阳性。1例失访,5例于术后2~11个月死亡。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,早期诊断和完整的外科切除有重要意义,预后较差。

Adult Prostate Sarcoma: A Report of 6 Cases with Clinical Analysis

Objective: To investigate the diagnosis, treatment and prognosis of sarcoma of the adult prostate.Methods: We reported 6 cases of sarcoma of the adult prostate,of which 3 were leiomyosarcoma,2 rhabdomyosarcoma and 1 malignant neurilemoma,2 at Ghavimi Stage II,3 at Stage III and 1 at Stage IV.The patients were aged from 18 to 44 years(mean 31 years) and their disease course ranged from 3 to 12 months(mean 7 months).Five of them received operation,radiotherapy and / or chemotherapy and 1 underwent cystostomy only.Results: Immunohistochemical dyeing showed vimentin to be positive while PSA and PAP negative in all the 6 cases,actin (HHF35) positive in the cases of leiomyosarcoma and rhabdomyosarcoma,and S-100 and lysozyme positive in the case of malignant neurilemoma.One case failed to be followed up,and the other 5 died 2-11 months after the operation.Conclusion: Sarcoma of the adult prostate initiates with the symptom of progressive dysuria,which can be diagnosed by DRE test and confirmed by needle biopsy.Early diagnosis and radical surgical resection may offer the best chance of survival,but with poor prognosis.