附睾脂肪肉瘤腹膜后及腹腔内转移1例报告并文献复习  

Epididymal liposarcoma with metastases to the retroperitoneal space and peritoneal cavity:A case report and literature review

作　　者：李俊龙 凡杰[1] 

机构地区：[1]南京医科大学附属上海一院临床医学院泌尿外科,上海200080 [2]绍兴市人民医院泌尿外科,浙江绍兴312000

出　　处：《中华男科学杂志》2017年第12期1103-1106,共4页National Journal of Andrology

摘　　要：目的:报告1例罕见的附睾脂肪肉瘤伴腹膜后及腹腔内多次转移病例,提高对本病的诊治水平。方法:回顾分析1例附睾脂肪肉瘤伴腹膜后及腹腔内多次转移患者的临床资料,结合国内外相关文献,探讨附睾脂肪肉瘤的临床表现、诊断及治疗。结果:经腹股沟切口行根治性高位睾丸切除术完整切除肿瘤,10年后出现腹膜后复发转移,肿块上至肾脏上极,下达盆腔,大小15.6 cm×9.4 cm×25.5 cm,包裹左肾及输尿管上段,行左肾及输尿管全长、腹膜后肿瘤切除手术,4年后再次出现腹膜后、腹腔内多发复发转移灶,再次行手术切除,随访1年,死于肺功能衰竭。结论:附睾脂肪肉瘤极为罕见,仔细的临床体检和影像学检查可协助诊断,但最终需病理确诊,应早期行根治性手术切除。放化疗对附睾脂肪肉瘤的作用存在争议。本病有较高的复发率,长期的密切随访是必要的。Objective： To report a rare case of epididymal liposarcoma with multiple metastases to the retroperitoneal space and peritoneal cavity for the purpose of improving the diagnosis and treatment of the disease. Methods ： We retrospectively analyzed the clinical data about a case of epididymal liposarcoma with multiple metastases to the retroperitoneal space and peritoneal cavity, re- viewed relevant literature at home and abroad, and investigated the presentation, diagnosis and treatment of the disease. Results： A 47-year-old male patient with epididymal liposarcoma underwent radical left orchiectomy with high ligation of the spermmatic cord. Ten years later, recurrence and metastasis were observed in the retroperitoneal space with a mass of 15.6 ×9.4cm×25.5cm occupying an area from the upper pole of the left kidney to the pelvic cavity and enclosing the left kidney and upper ureter, for which the patient re- ceived radical resection of the retroperitoneal tumor. However, multiple retroperitoneal and intraperitoneal metastases occurred again 4 years later, which was treated by another surgical resection. The patient died of lung failure a year later. Conclusion ： Epididymal li- posarcoma is a rare entity, which can be diagnosed by careful clinical and radiological examinations and confirmed by pathology. For its treatment, radical inguinal orchiectomy should be performed as early as possible, but the roles of adjuvant radiotherapy and chemotherapy remain controversial. Given the high rate of recun＇ence and metastasis, long-term follow-up is necessitated for the patient postopera- tively.

关 键 词：附睾 脂肪肉瘤 睾丸旁肿瘤 复发 转移 

分 类 号：R737.21[医药卫生—肿瘤]