前列腺黏液性纤维肉瘤误诊1例并文献复习  

One case of misdiagnosis of myxoid fibrosarcoma of the prostate and literature review

作　　者：倪庆节[1] 诸靖宇[1] 徐智慧[2] 宋晨[1] NI Qing-jie;ZHU Jing-yu;XU Zhi-hui;SONG Chen(Department of Urology,Third People′s Hospital of Hangzhou,Hangzhou 310009,China)

机构地区：[1]杭州市第三人民医院泌尿外科,310009 [2]浙江省人民医院泌尿外科

出　　处：《现代泌尿生殖肿瘤杂志》2018年第4期232-235,共4页Journal of Contemporary Urologic and Reproductive Oncology

摘　　要：目的探讨前列腺黏液性纤维肉瘤的诊治方法。方法分析1例前列腺黏液性纤维肉瘤患者的诊治资料,并结合文献进行复习总结。结果患者,男,48岁,因"排尿困难、肉眼血尿伴下腹部胀痛2d"入院。B超及CT检查均诊断为前列腺增生、前列腺囊肿待查。首次行经尿道前列腺电切术,病理诊断为前列腺间质细胞结节状增生,小区细胞增生活跃。术后3个月症状复发,再次行耻骨上前列腺切除术,术后病理诊断为前列腺黏液性纤维肉瘤。免疫组化:Vim(++),CD34(-),CD117(-),S-100(-),CK(-),EMA(-),Act(-),HMB45(-),CgA(-),Syn(-),MG(-)。术后肿瘤迅速复发并浸润至膀胱、盆腔与前腹壁,但无远处转移,包括PSA在内的肿瘤指标也长期正常,经多次膀胱切开减瘤手术治疗无效,最终因多脏器功能衰竭于初次发病后15个月死亡。结论前列腺黏液性纤维肉瘤具有前列腺肉瘤的共性和黏液瘤特性,其诊治有待进一步研究探索。Objective To explore the diagnosis and treatment of myxoid fibrosarcoma of the prostate.Methods Diagnosis and treatment of one case of myxoid fibrosarcoma of the prostate was analysed and literature was reviewed.Results This patient was a 48-year-old who was admitted to hospital because of difficulty in urination, gross hematuria and lower abdominal pain for 2 days. B-ultrasound and CT scan were diagnosed as benign prostatic hyperplasia and prostatic cyst to be investigated. Transurethral resection of the prostate was performed at first, then the pathological diagnosis was nodular hyperplasia of prostatic stromal cells, cell proliferation was active. Three months later the patient recurred so suprapubic prostatectomy was done. Postoperative pathological diagnosis was myxoid fibrosarcoma of the prostate. Immunohistochemistry showed： Vim （＋＋）, CD34 （-）, CD117 （-）, S-100 （-）, CK（-）, EMA （-）, Act （-）, HMB45 （-）, CgA （-）, Syn （-）, MG （-）. Tumor progressed rapidly and infiltrated into the bladder, pelvic cavity and anterior abdominal wall, but there was no distant metastasis. The tumor indices including PSA were also normal for a long time. After several times of failure of bladder incisions and cytoreductive surgeries, the patient eventually died of multiple organ failure 15 months after the initial onset.Conclusions Myxoid fibrosarcoma of the prostate is the commonality of prostate sarcoma and the characteristics of myxoma. The diagnosis and treatment need further research and exploration.

关 键 词：前列腺 黏液性 纤维肉瘤 误诊 治疗 

分 类 号：R737.25[医药卫生—肿瘤]