论文部分内容阅读
目的提高对原发性睾丸胚胎性横纹肌肉瘤早期诊断的认识,探讨其有效合理的治疗方案。方法总结1例原发性睾丸巨大胚胎性横纹肌肉瘤患儿资料,并复习该病的相关文献。结果持续硬膜外麻醉下行左侧睾丸高位根治性切除术,病理检查示:肿瘤组织细胞丰富,大小不等,呈梭形或椭圆形,其内可见横纹;部分区黏液丰富,黏液内散在星形或小梭形细胞,细胞核大深染;另见大片坏死。免疫组化示:DES(++),VIM(+),CK(-),EMA(-),CD34(-),CD99(-),BCL-2(-),SMA(-),MYO-D1(-),a-inhibin(-)。诊断为:左睾丸胚胎性横纹肌肉瘤。术后给予放化疗,随访6个月,B超、MRI复查未见复发及腹膜后淋巴转移,性激素及AFP水平未见异常,勃起功能正常。结论对青少年睾丸增长迅速的肿物应考虑横纹肌肉瘤的可能;睾丸巨大胚胎性横纹肌肉瘤可行单侧睾丸高位根治性切除术后辅以放化疗的综合治疗方案,其预后较好;并坚持终生密切随访。
Objective To improve the understanding of the early diagnosis of primary testicular embryonal rhabdomyosarcoma and to explore its effective and reasonable treatment. Methods One case of primary testes with giant embryonal rhabdomyosarcoma was retrospectively reviewed and the related literature was reviewed. Results Epidural anesthesia continued down the left high testosterone radical resection, the pathological examination showed: tumor cells rich, ranging in size, was spindle or oval, which can be seen horizontal stripes; part of the mucus rich mucus within scattered Star or spindle cells, large nuclei stained; see also large necrosis. Immunohistochemistry showed that there was no significant difference in the expression levels of DES (+), VIM (+), CK (-), EMA (-), CD34 (-), CD99 (-), BCL- D1 (-), a-inhibin (-). Diagnosis: Left testicular embryonal rhabdomyosarcoma. Radiochemotherapy was given postoperatively. All the patients were followed up for 6 months. No recurrence and retroperitoneal lymphatic metastasis were detected by B ultrasound or MRI. No abnormalities of sex hormone and AFP were found. Erectile function was normal. Conclusions Rhabdomyosarcoma should be considered for the rapid growth of testicular in adolescents. The large embryonic rhabdomyosarcoma of testes is feasible in combination with chemoradiotherapy after radical radical resection of the unilateral testes and has a good prognosis. Follow-up.