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目的探讨原发性附睾肿瘤的临床特点、病理类型及临床诊治方法。方法回顾性总结42例接受手术治疗的原发性附睾肿瘤患者临床资料。42例附睾肿瘤中良性肿瘤37例(88.1%),其中附睾腺瘤样瘤21例,平滑肌瘤9例,纤维假瘤2例,其余5例分别为乳头状囊腺瘤、血管平滑肌脂肪瘤、纤维瘤、纤维脂肪瘤和硬化性血管瘤。恶性肿瘤5例(11.9%),为附睾腺癌2例,非霍奇金淋巴瘤、横纹肌肉瘤和平滑肌瘤肉瘤变各1例。良性肿瘤作单纯肿瘤或患侧附睾切除,恶性肿瘤(除平滑肌瘤肉瘤变患者外)行根治性附睾睾丸切除术,术后辅助放和/或化疗。结果良性肿瘤27例获随访,预后良好,术后无复发。恶性肿瘤5例均获随访,预后差,2例腺癌患者均于术后12个月死亡,横纹肌肉瘤患者术后20个月时广泛转移,非霍奇金淋巴瘤患者和平滑肌瘤肉瘤变患者健在。结论附睾肿瘤大部分为良性,手术切除效果好。恶性肿瘤少见,但预后较差,综合治疗可能会提高疗效。
Objective To investigate the clinical features, pathological types and clinical diagnosis and treatment of primary epididymal tumors. Methods The clinical data of 42 patients with primary epididymal tumors undergoing surgery were retrospectively reviewed. Forty-two cases of benign tumors in epididymal tumors were found in 37 cases (88.1%), including 21 cases of epididymal adenoma, 9 cases of leiomyoma and 2 cases of fibrous pseudotumor. The other 5 cases were papillary cystadenoma, angiomyolipoma , Fibroids, fibrolipomas and sclerosing hemangiomas. Malignant tumors in 5 cases (11.9%), 2 cases of epididymal adenocarcinoma, non-Hodgkin’s lymphoma, rhabdomyosarcoma and leiomyosarcoma in 1 case. Benign tumors as a simple tumor or ipsilateral epididymal resection, malignant tumors (except leiomyosarcoma patients) underwent radical epididymoidectomy, adjuvant radiotherapy and / or chemotherapy. Results Twenty-seven benign tumors were followed up with good prognosis and no relapse after operation. Malignant tumors were followed up in 5 cases, the prognosis was poor, 2 cases of adenocarcinoma patients died after 12 months, rhabdomyosarcoma patients after 20 months of extensive metastasis, non-Hodgkin’s lymphoma and leiomyosarcoma The patient is alive. Conclusion Most of the epididymal tumors are benign and the resection effect is good. Malignant tumor is rare, but the prognosis is poor, and comprehensive treatment may improve the curative effect.