摘要
目的:探讨儿童睾丸肿瘤的临床特点、诊治方法及预后。方法:回顾性分析我院2015年6月—2018年12月收治的52例儿童睾丸肿瘤患者的临床资料,年龄2个月~13岁,平均4.3岁。发病时间1 d~3年,平均2个月,术前阴囊彩色多普勒超声检查示睾丸肿瘤直径0.5~7 cm,平均1.5 cm。腹盆腔CT或MRI检查均未见异常。45例患儿肿瘤标记物AFP结果正常,7例升高。其中44例患儿行保留睾丸的肿瘤剜除术,8例行根治性睾丸肿瘤切除术。结果:52例患儿手术均顺利完成,手术时间30~65 min,平均45 min。术后病理诊断14例为表皮样囊肿,24例为成熟性畸胎瘤,2例为不成熟畸胎瘤,3例为睾丸囊肿,1例为睾丸局部钙化,7例为卵黄囊瘤。7例睾丸卵黄囊瘤患儿根据肿瘤分期3例患儿术后接受化疗,其余4例定期门诊复查。术后随访6~36个月,平均26个月,所有病例均存活;7例卵黄囊瘤患儿中6例术后定期复查胸片,B超及血AFP均正常,未见肿瘤复发或者转移;1例患儿术后肿瘤复发接受再次手术治疗及化疗。结论:儿童睾丸肿瘤一般以成熟性畸胎瘤和表皮样囊肿居多,保留睾丸的手术是可靠的,睾丸肿瘤的大小影响其实施。术中快速冰冻病理检查对手术的方案选择有重要的指导意义,确定为良性者行保留睾丸手术,否则行根治性睾丸切除术。对于术前AFP增高,睾丸肿瘤短时间明显增大的患儿,需要高度警惕恶性肿瘤的可能,睾丸恶性肿瘤根据病理结果及肿瘤分期进一步化疗或者放疗。
Objective: To investigate the clinical features, diagnosis, treatment and prognosis of testicular tumor in children. Methods: The clinical data of 52 pediatric patients admitted to our hospital from June 2015 to December 2018 were retrospectively analyzed, aged from two months to 13 years, with an average age of 4.3 years. The onset time was 1 day to 3 years, with an average of 2 months. Preoperative color doppler ultrasonography of the scrotum showed testicular tumor with a diameter of 0.5-7 cm, with an average of 1.5 cm. No abnormality was found in CT or MRI examination of the abdomen and pelvis. AFP, a tumor marker, was normal in 45 children and elevated in 7. Among them, 44 children underwent tumor enucleation with testicular preservation. Eight children received radical resection of testicular tumor. Results: The operation time of 52 children patients was 30-65 minutes, with an average of 45 minutes. Postoperative pathology diagnosed 14 cases of epidermoid cyst, 24 cases of mature teratoma, 2 cases of immature teratoma, 3 cases of testicular cyst, 1 case of testicular local calcification, and 7 cases of yolk sac tumor. Three of the seven children with testicular yolk sac tumor received chemotherapy after surgery according to the tumor stage, and the other four received regular outpatient review. The patients were followed up for 6-36 months, with an average of 26 months. All the patients survived. In 6 of the 7 children with yolk sac tumor, chest radiographs were regularly reviewed after surgery. B-ultrasound and AFP were normal, and there was no tumor recurrence or metastasis. One patient received reoperation and chemotherapy because of tumor recurrence after surgery. Conclusion: Mature teratoma and epidermoid cyst are the most common testicular tumors in children. During the operation, rapid freezing pathological examination is important for the selection of the operation plan, and the testicular preservation surgery should be performed for the benign patients, otherwise, radical orchiectomy should be performed. For children with increased preoperative AFP and significantly increased testicular tumor in a short period of time, it is necessary to be on high alert for the possibility of malignant tumor. Testicular malignant tumor should be further treated with chemotherapy or radiotherapy according to the pathological results and tumor staging.
作者
陈子英
徐国栋
张富义
许海华
王晓佳
CHEN Ziying;XU Guodong;ZHANG Fuyi;XU Haihua;WANG Xiaojia(Department of Urology,Tianjin Children's Hospital,Tianjin,300074,China)
出处
《临床泌尿外科杂志》
CAS
2021年第2期116-119,共4页
Journal of Clinical Urology
关键词
睾丸肿瘤
治疗
儿童
testicular tumor
treatment
children
