以睾丸占位为表现的无精子症的鉴别诊断与治疗:2例报告及文献复习  

The differential diagnosis and treatment experience of azoospermia with testicular space occupying:two cases report and literature review

作　　者：杨晓健 张炎[2] 冯嘉荣 刘卓杰 张浩[3] YANG Xiaojian;ZHANG Yan;FENG Jiarong;LIU Zhuojie;ZHANG Hao(Andrology of Reproductive Center,Dongguan Maternal and Child Health Care Hospital,Dongguan 523000,Guangdong,China;Department of Infertility and Sexual Medicine,the Third Affiliated Hospital of Sun Yat-Sen University,Guangzhou 510630,Guangdong,China;Department of Urology,the Third Affiliated Hospital of Sun Yat-Sen University,Guangzhou 510630,Guangdong,China)

机构地区：[1]东莞市妇幼保健院生殖中心男科,广东东莞523000 [2]中山大学附属第三医院不育与性医学科,广州510630 [3]中山大学附属第三医院泌尿外科,广州510630

出　　处：《中国性科学》2022年第10期8-11,共4页Chinese Journal of Human Sexuality

基　　金：广东省基础与应用基础研究基金(2019A1515010975)。

摘　　要：目的探讨以睾丸占位为表现的无精子症的鉴别诊断与治疗经验。方法报告2例以睾丸占位为表现的无精子症,通过阴囊彩超、CT、磁共振成像、内分泌激素、基因检测等检查明确诊断。结果一例睾丸占位诊断为睾丸肾上腺残余瘤,使用糖皮质激素治疗,患者术后一年复查精液基本恢复正常,睾丸结节较前缩小。另一例睾丸占位诊断为睾丸间质细胞瘤,行睾丸切除术,患者术后4个月复查性激素恢复正常,术后5个月配偶自然怀孕,检查精液示精子数量恢复正常,但1个月后胎儿停止发育,未见睾丸肿瘤复发。结论以睾丸占位为表现的无精子症病因多样,不同的病因其治疗方法完全不一样,正确的鉴别诊断是治疗的关键。Objective To discuss the differential diagnosis and treatment experience of azoospermia with testicular space occupying.Methods Two cases of azoospermia with testicular space occupying,which were confirmed through ultrasound,computed tomography,magnetic resonance imaging,hormone and gene detection.Results One case was diagnosed as testicular adrenal rest tumor and treated with prednisone,sperm concentration and vitality recovered to the normal level and the testicular tubercle shrinked one year after surgery.Another case was diagnosed as testicular Leydig cell tumor and performed orchiectomy,the sex hormone recovered to the normal level four months after surgery;five months after the operation,the sprouse became pregnant naturally,and the sperm count returned to normal.However,the fetus stopped developing one month later,and no testicular tumor recurrence was observed.Conclusions The pathogeny of azoospermia with testicular space occupying is complicated,the treating methods corresponding different pathogeny are completely different.The corrected differential diagnosis is the key to treatment.

关 键 词：无精子症 睾丸占位 睾丸肾上腺残余瘤 睾丸间质细胞瘤 

分 类 号：R697[医药卫生—泌尿科学]