北京大学学报(医学版) ›› 2018, Vol. 50 ›› Issue (4): 740-742. doi: 10.3969/j.issn.1671-167X.2018.04.030

• 病例报告 • 上一篇    下一篇

经尿道前列腺电切术治疗复发性前列腺囊腺瘤1例

杨文博1,张晓威1,杨健2,李清1,徐涛1,白文俊1△   

  1. (1. 北京大学人民医院泌尿外科,北京100044; 2. 山东阳光融和医院泌尿外科,山东潍坊261000)
  • 出版日期:2018-08-18 发布日期:2018-08-18
  • 通讯作者: 白文俊 E-mail:bai-wj@163.com

Transurethral resection of prostate treatment for recurrence of a multilocular prostatic cystadenoma: a case report

YANG Wen-bo1, ZHANG Xiao-wei1, YANG Jian2, LI Qing1, XU Tao1, BAI Wen-jun1△   

  1. (1. Department of Urology, Peking University People’s Hospital, Beijing 100044, China; 2. Department of Urology, Shandong Sunshine Union Hospital, Weifang 261000, Shandong, China)
  • Online:2018-08-18 Published:2018-08-18
  • Contact: BAI Wen-jun E-mail:bai-wj@163.com

摘要: 多房性前列腺囊腺瘤(multilocular prostatic cystadenoma, MPC)是一种罕见的前列腺组织来源的良性肿瘤,肿瘤体积通常较大,位于直肠和膀胱之间[1]。患者主要表现为泌尿系梗阻症状,如排尿中断、尿流较细、尿不尽等。影像学检查如前列腺超声、盆腔磁共振成像不仅可以提供肿瘤的位置信息,以及与周围器官的关系,还有助于与其他恶性肿瘤鉴别。由于MPC罕见且缺乏长期的随访报告,该病的诊断和治疗尚无定论。2017年 8月北京大学人民医院泌尿外科收治MPC经尿道电切术后复发 1 例,并成功行经尿道前列腺电切术(transurethral resection of prostate, TURP), 现报告如下。

关键词: 前列腺囊腺瘤, 前列腺, 多房性

Abstract: Multilocular prostatic cystadenoma (MPC) is a rare benign tumor that originates from the prostate itself. MPC is usually characterized by large multilocular cysts located between the rectum and bladder. The clinical presentation includes obstructive voiding symptoms, such as poor stream, intermittency, sensation of incomplete emptying, acute urinary retention and sometimes constipation symptoms due to mechanical compression of the lower intestine. Most of the previously reported patients with MPC underwent open surgery. Although the natural history of MPC remains unknown, surgical excision may not always be necessary. Here we report the case of a 49-year-old male, treated by transurethral electroresection of prostate (TURP) for prostate cyst one and half years before.His biopsy of TURP showed benign prostatic tissue with no evidence of malignancy. However, the symptoms of urinary tract obstruction were obviously aggravated after the operation. Acute urinary retention occurred intermittently 3 times. In our hospital, his total prostate specific antigen (tPSA)was 5.440 μg/L,free prostate specific antigen (fPSA ) was 1.528 μg/L. After examination, it was considered as benign lesions clearly. In the operation of TURP, we found that the tumor was multilocular cystic. Histologically,the cell was mucus. Concerning the immunophenotype,CK5/6(+), p40(+), PSA(+), P504S(+), PAX2(-), PAX8(-), MUC1(+), MUC5ac(+), the results of special staining were as follows: AB(+), PAS(+).At the end of the follow up 3 months later, the routine semen analysis results showed that his semen volume was 3 mL and the sperm density and sperm mobility were normal. At the end of the follow up eight months later, the patient remained free of lower urinary tract symptoms and there were no signs of recurrence. His international prostate symptom score (I-PSS) had dropped from 32 to 4, and quality of life score (QOL) had dropped from 6 to 2. MPC is a rare benign tumor originating from the prostate. TURP may aggravate the symptoms of lower urinary tract obstruction in patients with MPC, and may be temporarily observed for some asymptomatic young and middle-aged patients.

Key words: Cystadenoma, Prostate, Multilocular

中图分类号: 

  •  
[1] 李志存, 吴天俣, 梁磊, 范宇, 孟一森, 张骞. 穿刺活检单针阳性前列腺癌术后病理升级的危险因素分析及列线图模型构建[J]. 北京大学学报(医学版), 2024, 56(5): 896-901.
[2] 黄教悌,胡菁,韩博. 治疗相关神经内分泌前列腺癌机制研究与靶向治疗新进展[J]. 北京大学学报(医学版), 2024, 56(4): 557-561.
[3] 邢念增,王明帅,杨飞亚,尹路,韩苏军. 前列腺免活检创新理念的临床实践及其应用前景[J]. 北京大学学报(医学版), 2024, 56(4): 565-566.
[4] 田宇轩,阮明健,刘毅,李德润,吴静云,沈棋,范宇,金杰. 双参数MRI改良PI-RADS评分4分和5分病灶的最大径对临床有意义前列腺癌的预测效果[J]. 北京大学学报(医学版), 2024, 56(4): 567-574.
[5] 姚凯烽,阮明健,李德润,田宇轩,陈宇珂,范宇,刘毅. 靶向穿刺联合区域系统穿刺对PI-RADS 4~5分患者的前列腺癌诊断效能[J]. 北京大学学报(医学版), 2024, 56(4): 575-581.
[6] 欧俊永,倪坤明,马潞林,王国良,颜野,杨斌,李庚午,宋昊东,陆敏,叶剑飞,张树栋. 肌层浸润性膀胱癌合并中高危前列腺癌患者的预后因素[J]. 北京大学学报(医学版), 2024, 56(4): 582-588.
[7] 颜野,李小龙,夏海缀,朱学华,张羽婷,张帆,刘可,刘承,马潞林. 前列腺癌根治术后远期膀胱过度活动症的危险因素[J]. 北京大学学报(医学版), 2024, 56(4): 589-593.
[8] 于书慧,韩佳凝,钟丽君,陈聪语,肖云翔,黄燕波,杨洋,车新艳. 术前盆底肌电生理参数对前列腺癌根治性切除术后早期尿失禁的预测价值[J]. 北京大学学报(医学版), 2024, 56(4): 594-599.
[9] 薛蔚,董樑,钱宏阳,费笑晨. 前列腺癌新辅助治疗与辅助治疗的现状及进展[J]. 北京大学学报(医学版), 2023, 55(5): 775-780.
[10] 刘毅,袁昌巍,吴静云,沈棋,肖江喜,赵峥,王霄英,李学松,何志嵩,周利群. 靶向穿刺+6针系统穿刺对PI-RADS 5分患者的前列腺癌诊断效能[J]. 北京大学学报(医学版), 2023, 55(5): 812-817.
[11] 毛海,张帆,张展奕,颜野,郝一昌,黄毅,马潞林,褚红玲,张树栋. 基于MRI前列腺腺体相关参数构建腹腔镜前列腺癌术后尿失禁的预测模型[J]. 北京大学学报(医学版), 2023, 55(5): 818-824.
[12] 袁昌巍,李德润,李志华,刘毅,山刚志,李学松,周利群. 多参数磁共振成像中动态对比增强状态在诊断PI-RADS 4分前列腺癌中的应用[J]. 北京大学学报(医学版), 2023, 55(5): 838-842.
[13] 张展奕,张帆,颜野,曹财广,李长剑,邓绍晖,孙悦皓,黄天亮,管允鹤,李楠,陆敏,胡振华,张树栋. 近红外荧光靶向探针用于前列腺神经血管束术中成像[J]. 北京大学学报(医学版), 2023, 55(5): 843-850.
[14] 许素环,王蓓蓓,庞秋颖,钟丽君,丁炎明,黄燕波,车新艳. 等体温膀胱冲洗对经尿道前列腺电切术患者干预效果的meta分析[J]. 北京大学学报(医学版), 2023, 55(4): 676-683.
[15] 刘圣杰,侯惠民,吕政通,丁鑫,王璐,张磊,刘明. 双极雄激素序贯免疫检查点抑制剂治疗转移性去势抵抗性前列腺癌4例[J]. 北京大学学报(医学版), 2022, 54(4): 766-769.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!