摘要
目的:探讨睾丸原发性神经内分泌癌的起源、诊断要点和治疗方法,提高对该疾病的认识。方法:回顾性分析我院收治的1例睾丸原发性神经内分泌癌患者的资料,并复习有关文献。结果:患者左侧睾丸有一无痛肿块,质硬。彩超扫描证实左侧睾丸内存在一2.7 cm×2.3 cm×3.1 cm低回声实性团块,包膜完整,界限清楚,肿块内血流信号丰富;腹膜后、腹股沟彩超检查未见肿大淋巴结。血清肿瘤标记物β-HCG、CEA和AFP未见异常。手术完整切除肿瘤,术后病检提示为睾丸神经内分泌癌。病变组织起源于神经内分泌细胞,癌细胞类圆形,胞质伊红染,核圆形,颗粒状,癌细胞呈巢状或岛状排列。癌细胞弥漫性表达突触素、嗜铬颗粒A和细胞角蛋白。结论:睾丸原发性神经内分泌癌罕见,临床表现缺乏特异性,组织学特点和免疫组化标记物是诊断该病的主要依据,需与转移性类癌和混合性类癌相鉴别。早期诊断并手术效果良好,术后应密切随访预防复发和转移。
Objective：To discuss the origin, diagnosis and treatment of primary neuroendocrine carcinoma of the testis, so as to improve the understanding of this disease. Methods：A retrospective study was done in one case of primary neuroendocrine tumor of the testis in our hospital,combing with the analysis of domestic and foreign literatures. Results： There was a solid mass with 2.7 cmX 2.3 cmX 3.1 cm in the left side of the testis without tenderness in the patient. The hypoe- cboic mass in the testis was confirmed by ultrasound scan with complete involucrum and clear boundary, rich blood signals within the mass. Retroperitoneal and inguinal ultrasound confirmed that there was no apparent swelling lymph node. Serum marks of tumor, ~HCG,CEA and AFP were normal. Tumor was excised by surgery to get good effects and the pathologic examination after operation indicated it was neuroendocrine carcinoma of testis. The lesions were originated from neuroen- docrine cells. Histologically, round tumor ceils and eosinophilic cytoplasm with round granular nuclei, nidus-like and island patterns with tumor cells. Immunohistochemical staining for synaptophysin, chromngranin A and keratinized cell protein showed diffusely positive expression in the tumor cells. We must differentiate this disease from metastatic one and mixed carcinoid tumor, surgery may have a good effect in early stage of this disease. Conclusions： Primary testicular neuroendo- crine tumor is extremely rare without specific feature in clinical performance, The diagnosis of this disease mainly depends on histological features and special marks checked by immunohistochemistry before differentiates metastatic and mixed tumors. Early diagnosis and surgery are key points to get good effects. Close follow-up after surgery is important to pre- vent recurrence and metastasis of this disease.
出处
《临床泌尿外科杂志》
北大核心
2011年第10期767-768,771,共3页
Journal of Clinical Urology
