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其他题名Malignant mesothelioma of the tunica vaginalis testis (a case report and literature review)
彭靖; 张志超; 袁亦铭; 宋卫东; 高冰; 辛钟成; 金杰
关键词恶性间皮瘤 睾丸鞘膜 Malignant Mesothelioma Tunica Vaginalis Testis
收录类别中国科技核心期刊 ; 中文核心期刊 ; CSCD
文章类型Journal Article
摘要目的 探讨睾丸鞘膜恶性间皮瘤临床表现、病理特征、治疗方法和预后情况.方法 睾丸鞘膜恶性间皮瘤患者1例,34岁,因右侧阴囊肿大5年,进行性增大15d入院.查体:右侧阴囊肿大、囊性,于睾丸上方可触及质硬肿物,表面光滑、轻压痛,与睾丸、附睾界限尚清.β-人绒毛膜促性腺激素和甲胎蛋白检测正常.阴囊超声于右侧睾丸鞘膜上方探及2.05 cm×1.97 cm混合回声的实性肿物,边界毛糙,内部回声欠均匀.结果蛛网膜下腔麻醉下手术切除鞘膜及肿物.病理报告:肿物切面灰白色,质硬,边界欠清晰.镜下可见鞘膜间皮细胞向上皮细胞和间质细胞双向分化,以上皮细胞增殖为主,上皮细胞有明显异形性,可见有丝分裂相;免疫组化染色角蛋白和波形蛋白呈强阳性.病理诊断为低度恶性的睾丸鞘膜间皮瘤.1个月后行右侧睾丸根治加右侧阴囊切除术,肿瘤未浸润临近的精索、睾丸、微血管和淋巴管等.随访38个月,患者生存良好,肿瘤无复发.结论睾丸鞘膜恶性间皮瘤多表现为鞘膜积液,确诊需依靠病理检查,本病易发生浸润和远处转移,患者生存期较短,术后需密切随访.低度恶性的间皮瘤患者经早期治疗生存期可明显延长. :肿物切面灰白色,质硬,边界欠清晰.镜下可见鞘膜间皮细胞向上皮细胞和间质细胞双 分化,以上皮细胞增殖为主,上皮细胞有明显异形性,可见有丝分裂相;免疫组化染色角蛋白和波形蛋白呈强阳性.病理诊断为低度恶性的睾丸鞘膜间皮瘤.1个月后行右侧睾丸根治加右侧阴囊切除术,肿瘤未浸润临近的精索、睾丸、微血管和淋巴管等.随访38个月,患者生存良好,肿瘤无复发.结论睾丸鞘膜恶性间皮瘤多表现为鞘膜积液,确诊需依靠病理检查,本病易发生浸润和远处转移,患者生存期较短,术后需密切随访.低度恶性的间皮瘤患者经早期治疗生存期可明显延长. :肿物切面灰白色,质硬,边界欠清晰.镜下可见鞘膜间皮细胞向上皮细胞和间质细胞双 分化,以上皮细胞增殖为主,上皮细胞有明显异形性,可见有丝分裂相;免疫组化染色角蛋白和波形蛋白呈强阳性.病理诊断为低度恶性的睾丸鞘膜间皮瘤.1个月后行右侧睾丸根治加右侧阴囊切除术,肿瘤未浸润临近的精索、睾丸、微血管和淋巴管等.随 Objective To review the clinical manifestation,pathological characteristics,treat ment and prognosis of malignant mesothelioma of the tuniea vaginalis testis.Methods A case of ma lignant mesothelioma of the tunica vaginalis testis was reported and relative literature was reviewed.A34 year old man was admitted to hospital with a history of aggravated hydroeele for 5 years.A hardtumor was palpated above the right testis,which was smooth and slight tenderness.The level of β-hCG and AFP was normal.Ultrasonography revealed a 2.05 cm× 1.97 cm,well demarcated,mixedecho tumor.Results An operation was performed to incise the tumor and tunica vaginalis undersubarachnoid space block anesthesia.The tumor was histologically diagnosed as low potential malig nant mesothelioma of the tunica vaginalis testis.Microscopic examination showed that the tumor wasmalignant with a biphasic pattern composed of epithelial and stromal components.The former compo nent was dominant.The epithelial cells proliferated obviously with atypia and mitosis.Immunohisto chemical staining showed cytokeratin and vimentin were strongly positive.The capillary,lymph ves sel,spermatic cord and testis were not infiltrated.Right radical orchiectomy and right scrotectomywas performed one month after the first operation.There was no evidence of relapse during 38 monthfollow up after operation.Conclusions The major symptom of patients with malignant mesotheliomais hydrocele,malignant mesothelioma is diagnosed by histopathology.Due to the invasive potential ofthis disease and the risk of tumor recurrence,radical orchiectomy and close follow up are strongly rec ommended.
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作者单位100009 北京大学第一医院,北京大学泌尿外科研究所,男科中心
Recommended Citation
GB/T 7714
彭靖,张志超,袁亦铭,等. 睾丸鞘膜恶性间皮瘤一例报告[J]. 中华泌尿外科杂志,2008,29(10):712-714.
APA 彭靖.,张志超.,袁亦铭.,宋卫东.,高冰.,...&金杰.(2008).睾丸鞘膜恶性间皮瘤一例报告.中华泌尿外科杂志,29(10),712-714.
MLA 彭靖,et al."睾丸鞘膜恶性间皮瘤一例报告".中华泌尿外科杂志 29.10(2008):712-714.
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