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目的:提高睾旁胚胎型横纹肌肉瘤的诊治水平。方法:回顾性分析5例睾旁胚胎型横纹肌肉瘤患者的临床资料,结合文献复习进行讨论。结果:5例患者中精索胚胎型横纹肌肉瘤2例、附睾胚胎型横纹肌肉瘤2例、鞘膜横纹肌肉瘤1例,临床病理分期Ⅰ期2例,Ⅱ期1例,Ⅳ期2例。5例患者最终均行根治性睾丸切除术及肿块完整切除术。1例Ⅰb期和1例Ⅱ期患者术后采用异环磷酰胺、长春新碱、足叶乙甙、丝裂霉素、顺铂化疗并配合局部放疗,余3例未行进一步治疗。2例Ⅰ期、1例Ⅱ期患者随访28、18、12个月未见复发和转移,1例Ⅳ期患者随访6个月后死于多发转移,1例Ⅳ期随访6个月未见复发和转移,后失访。结论:早期诊断,根治性手术并辅助化疗、放疗是治疗睾旁胚胎型横纹肌肉瘤的有效手段。
Objective: To improve the diagnosis and treatment of embryo-type rhabdomyosarcoma. Methods: A retrospective analysis of 5 cases of patients with testicular embryonal rhabdomyosarcoma clinical data, combined with the literature review to be discussed. Results: There were 2 cases of spermatogenic rhabdomyosarcoma of spermatic cord, 2 cases of embryonic rhabdomyosarcoma of epididymis, 1 case of rhabdomyosarcoma of sheath, 2 cases of stage Ⅰ in clinicopathological stage, 1 case in stage Ⅱ and 2 cases in stage Ⅳ. All 5 patients underwent radical orchidectomy and complete resection of the tumor. One case of stage Ib and one case of stage II were treated with ifosfamide, vincristine, etoposide, mitomycin, cisplatin and local radiotherapy, while the remaining three cases were treated without further treatment. No recurrence and metastasis were found in 2 cases of stage Ⅰ and stage Ⅱ in 28,18 and 12 months. One case of stage Ⅳ died of multiple metastases after 6 months of follow-up. One case of stage Ⅳ followed up for 6 months showed no recurrence And transfer, lost after the visit. Conclusion: Early diagnosis, radical surgery and adjuvant chemotherapy and radiotherapy are effective methods for the treatment of testicular embryonal rhabdomyosarcoma.