保留器官的睾丸部分切除术治疗睾丸腺瘤样瘤

doi:10.19723/j.issn.1671-167X.2019.02.032

摘要/Abstract

Abstract:

Objective: The incidence of testicular tumors is relatively low which are mainly malignant, so the main way to treat testicular tumors is radical testicular resection. Testicular adenomatoid tumor is a rare testicular benign tumor, but is easily misdiagnosed as malignant tumors with removal of organs. This article aims to explore the clinical features of testicular adenomatoid tumor and its treatment.Methods: There were 133 cases of testicular tumor in the Peking University Third Hospital from May 1994 to November 2016. We conducted a retrospective analysis of three patients who underwent the treatment of partial orchiectomy with preservation of the organ and were pathologically diagnosed with testicular adenomatoid tumor after surgery. The follow-up was done by outpatient clinics and telephone inquiry after surgery. The related literature was also reviewed for further discussion.Results: Of all the 133 patients, 116 had radical resection of the testis and 17 had partial testicular resection due to specific reasons (5 cases of epidermoid cyst, 4 cases of teratoma, 3 cases of seminoma, 3 cases of adenomatoid tumor, and 2 cases of Sertoli cell tumor). The mean age of the 3 patients was (42.67±10.97) years (30-49 years), the mean hospital stay was (9.00±5.20) d (6-15 d), the mean body mass index was (26.20±1.42) kg/m ² (25.00-27.76 kg/m ²), the mean serum human choionic gonadotophin (HCG) was (1.15±0.11) IU/L (1.07-1.23 IU/L) (all normal) and the mean serum alpha-fetoprotein (AFP) was (2.12±0.66) μg/L (1.65-2.58 μg/L) (both were normal). Ultrasound features revealed a clear or unclear border, solid, moderate echo nodule tumor in the testis. The mean maximal diameter of the tumor was (1.00±0.44) cm (0.50-1.30 cm), and the mean duration of intraoperative warm ischemia time was (19.67±17.10) min (0-31 min) (only the last two cases). No recurrence or malignant transformation was observed during the follow-up. Conclusion: Testicular adenomatoid tumor is mainly based on the characteristics of ultrasound to determine preoperatively, but easy to be misdiagnosed with testicular radical resection. The recommended surgery for adenomatoid tumor is partial resection of the testis via the inguinal approach according to the frozen section pathology to determine whether to retain the organ.

Key words: Testicular neoplasms, Adenomatoid tumor, Organ-sparing, Partial orchiectomy

中图分类号:

R737.21

叶剑飞,王冰,马潞林,赵磊,王国良,洪锴. 保留器官的睾丸部分切除术治疗睾丸腺瘤样瘤[J]. 北京大学学报（医学版）, 2019, 51(2): 365-368.

Jian-fei YE,Bing WANG,Lu-lin MA,Lei ZHAO,Guo-liang WANG,Kai HONG. Organ-sparing partial orchietectomy for testicular adenomatoid tumor[J]. Journal of Peking University(Health Sciences), 2019, 51(2): 365-368.

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参考文献 15

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No.	Age/years	Side	Chief complain
1	49	Left	Palpable mass in the left scrotum for 10 days
2	30	Right	Palpable mass in the right scrotum for 6 months
3	49	Right	Painful mass in the right testis for 2 months

No.	HCG/(IU/L)	AFP/(μg/L)	The largest diameter/cm	Approach	Surgery	Ischemia time/min
1	-	-	0.5	Scrotum	Partialorchiectomy	0
2	1.23	1.65	1.3	Inguinal	Partialorchiectomy	28
3	1.07	2.58	1.2	Inguinal	Partialorchiectomy	31