附睾横纹肌肉瘤3例报告并文献复习  

Epididymal rhabdomyosarcoma:a report of 3 cases and literature review

作　　者：何民心 李明睿 种铁[2] 翟晓强[2] HE Minxin;LI Mingrui;CHONG Tie;ZHAI Xiaoqiang(Graduate School,Medical Science Center of Xi'an Jiaotong University,Xi'an 710061;Department of Urology,Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China)

机构地区：[1]西安交通大学医学部研究生院,陕西西安710061 [2]西安交通大学第二附属医院泌尿外科,陕西西安710004

出　　处：《现代泌尿外科杂志》2022年第11期954-957,共4页Journal of Modern Urology

摘　　要：目的分析原发性附睾横纹肌肉瘤的临床特点并探讨其诊治方案。方法回顾性分析2019年10月-2021年11月西安交通大学第二附属医院泌尿外科收治的3例原发于附睾的胚胎型横纹肌肉瘤患者的临床资料,结合国内外相关文献资料进行复习、总结。结果3例患者年龄分别是18、19、17岁,以“无痛性阴囊内容物肿大”来诊。查体:附睾尾部可触及明显肿块,质硬,触痛阴性。彩超提示:附睾实性包块,内部血流信号丰富。睾丸肿瘤标志物均正常。3例患者均行手术治疗。其中2例患者首先行附睾肿瘤切除术,术后病理提示附睾横纹肌肉瘤,再行根治性睾丸切除术;1例术中直接行根治性睾丸切除术。2例术后未行放、化疗,其中1例于术后14个月死亡。1例行术后辅助性化疗,目前正在随访中。结论附睾横纹肌肉瘤好发于青少年男性,具有恶性程度高、预后差的特点,一经确诊应早期行根治性睾丸切除术,术后应辅助性化疗或放疗并需要密切随访。Objective To analyze the clinical features,diagnosis and treatment of primary epididymal rhabdomyosarcoma.Methods Clinical data of 3 patients with primary epididymal rhabdomyosarcoma treated in the Department of Urology,Second Affiliated Hospital of Xi’an Jiaotong University during Oct.2019 and Nov.2021 were retrospectively analyzed.Relevant literature was reviewed.Results The patients were 18,19 and 17 years old,respectively.All came to hospital due to“painless enlargement of the scrotal contents.”Physical examination indicated a hard,palpable mass with tenderness negative in epidi-dymis tail.Ultrasonic imaging suggested a solid mass with abundant internal blood flow signals.No testicular tumor marker was abnormal.All patients underwent surgical treatment,two of whom received tumor resection first and then radical orchiectomy after postoperative pathology indicated rhabdomyosarcoma of epididymis,and the other one underwent radical orchiectomy.Two patients didn’t receive radiotherapy or chemotherapy after surgery,and one of which died 14 months after surgery.One patient received adjuvant chemotherapy after surgery and is now being followed up.Conclusion Epididymal rhabdomyosarcoma usually occurs in adolescent males with high malignancy and poor prognosis.Once the diagnose is made,radical orchiectomy should be performed at an early stage,followed by adjuvant chemotherapy or radiotherapy and close follow-up.

关 键 词：附睾肿瘤 横纹肌肉瘤 胚胎型 诊断 手术治疗 

分 类 号：R697.2[医药卫生—泌尿科学]