原发性腹股沟精原细胞瘤1例报告及文献复习  

Primary inguinal seminoma:A case report and literature review

作　　者：金光俊 刘蕾[1] 王永刚[1] JIN Guangjun;LIU Lei;WANG Yonggang(Department of Urinary Surgery,China-Japan Union Hospital,Jilin University,Changchun 130033,China)

机构地区：[1]吉林大学中日联谊医院泌尿外科,吉林长春130033

出　　处：《吉林大学学报（医学版）》2024年第6期1728-1733,共6页Journal of Jilin University：Medicine Edition

基　　金：吉林省卫健委卫生科研人才专项项目(2023SCZ66)。

摘　　要：目的:分析1例腹股沟精原细胞瘤睾丸精原细胞瘤患者的临床资料,为该类患者诊断和治疗提供参考。方法:收集1例原发性腹股沟精原细胞瘤患者的临床症状、影像学特征、病理学表现和诊断及治疗方法,并进行文献复习。结果:患者,男性,43岁,因偶然发现左侧腹股沟肿物入院,专科查体肿块、边界尚清,表面欠光整,可触及结节和局部波动感,活动欠佳,无表皮溃疡,肤温略高,双侧睾丸形态和大小正常且无压痛。辅助检查,甲胎蛋白(AFP)2.3 mg·L^(-1)、β-绒毛膜促性腺激素(HCG)<0.1 IU·L^(-1)、乳酸脱氢酶(LDH)254.31 IU·L^(-1),肝功、肾功、血常规和凝血常规均正常,胸部CT、心电图、心脏彩超、肝胆脾胰彩超和后腹膜彩超均未见异常。肿瘤科术前穿刺病理结果提示精原细胞瘤,经临床综合分析后决定行腹股沟肿物切除术和腹股沟淋巴结清扫术,术后病理与术前病理结果一致,均为精原细胞瘤且伴腹股沟淋巴结转移,术后1、3、6和8个月随访,患者恢复良好,无任何不适,能从事轻度体力活动,且病情稳定,无进展表现,目前已于肿瘤科行3次放化疗。结论:原发性腹股沟精原细胞瘤治愈率高,恶性度普遍较低,对放疗和化疗敏感,预后良好。Objective:To analyze the clinical data of one patient with inguinal seminoma and testicular seminoma,and to provide the references for the diagnosis and treatment of such patients.Methods:The clinical data,imaging features,pathological manifestations,diagnosis,and treatment methods of one patient with primary inguinal seminoma were collected and the relevant literatures were reviewed.Results:The patient,a 43-year-old male,was admitted to hospital due to the incidental discovery of a left inguinal mass.The specialized examination results showed a mass with relatively clear boundary,rough surface,palpable nodules,local fluctuation,limited mobility and no epidermal ulceration.The skin temperature was slightly elevated.The morphology and size of both testes were normal with no tenderness.The auxiliary examination results showed that alpha-fetoprotein(AFP)level was 2.3 mg·L^(-1),beta-human chorionic gonadotropin(HCG)<0.1 IU·L^(-1),and the lactate dehydrogenase(LDH)level was 254.31 IU·L^(-1).The results of liver function,renal function,blood routine,and coagulation routine of the patient were all normal.The results of chest CT,ECG,cardiac ultrasound,liver-gallbladder-spleenpancreas ultrasound,and retroperitoneal ultrasound showed no abnormalities.The preoperative biopsy pathology from the oncology department suggested seminoma.After comprehensive clinical analysis,it was decided to perform the inguinal mass excision and inguinal lymph node dissection.The postoperative pathology was consistent with the preoperative findings,confirming that seminoma with inguinal lymph node metastasis.The follow-up results at 1,3,6,and 8 months after operation showed the patient recovered well,and there were no discomfort and capable of light physical activities.The condition remained stable without progression,and the patient had undergone three sessions of radiochemotherapy in the Oncology Department.Conclusion:Primary inguinal seminoma has a high cure rate,generally low malignancy,sensitivity to radiotherapy and chemotherapy,and re

关 键 词：腹股沟肿物 原发性精原细胞瘤 甲胎蛋白 绒毛膜促性腺激素 乳酸脱氢酶 

分 类 号：R699.8[医药卫生—泌尿科学]