江汉大学学报(自然科学版) ›› 2020, Vol. 48 ›› Issue (5): 59-64.doi: 10.16389/j.cnki.cn42-1737/n.2020.05.008

• 医学 • 上一篇    下一篇

隐睾混合型生殖细胞肿瘤1 例并文献复习

刘军1a,程平2,方登攀1b,朱涛*1b   

  1. 1. 江汉大学 a. 医学院,湖北 武汉 430056,b. 附属医院泌尿外科,湖北 武汉 430015;2. 华中科技大学 同济医学院附属协和医院急诊外科,湖北 武汉 430022
  • 发布日期:2020-09-22
  • 作者简介:刘军(1991— ),男,硕士生,研究方向:泌尿外科。
  • 基金资助:
    ZHU Tao

A Case of Mixed Cryptorchidism Germ Cell Tumor and Literature Review

LIU Jun1a,CHENG Ping2,FANG Dengpan1b,ZHU Tao*1b   

  1. 1. a. School of Medicine,Jianghan University,Wuhan 430056,Hubei,China,b. Department of Urology,Affiliated Hospital of Jianghan University,Wuhan 430015,Hubei,China;2. Department of Emergency Surgery,Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430022,Hubei,China)
  • Published:2020-09-22
  • Contact: 朱涛

摘要: 目 的 隐睾混合型生殖细胞肿瘤临床上极为罕见,旨在提高对该病全面认识,为本病提供合理有效的治疗方法,提高患者的生存率。方 法 回顾性分析1 例经病理证实为隐睾混合型生殖细胞肿瘤,含有4 种肿瘤成分(精原细胞瘤约50% + 未成熟畸胎瘤约25% + 卵黄囊瘤约20% + 胚胎性癌约5%)的临床资料,结合国内外文献进行分析。结 果 患者以“ 急腹症”表现入院,查血AFP、HCG、LDH 均升高,影像学检查示腹腔占位性病变,手术切除肿瘤及周围组织若干,经病理证实为隐睾混合型生殖细胞肿瘤,无周围组织侵犯。术后随访6 个月,无肿瘤复发及转移。结 论 隐睾混合型生殖细胞肿瘤的治疗要趁早,2 岁前行睾丸复位固定术能有效减少本病的发生。其治疗多为根治性切除联合BEP(博来霉素,依托泊苷、顺铂)化疗。预后多根据瘤体成分而异,肿瘤包含恶性成分胚胎性癌的预后差,而主要为精原细胞瘤成分的预后一般较好。

关键词: 隐睾, 混合型生殖细胞肿瘤, 病理学, 治疗, 预后

Abstract: Objective Mixed cryptorchidism germ cell tumor is extremely rare in clinical practice. This paper aims to improve the comprehensive understanding of the disease,provide reasonable and effective treatment methods for the disease,and improve the survival rate. Methods The retrospective analysis was performed on the clinical data of 1 case of mixed cryptorchidism germ cell tumor confirmed by pathology,which contained 4 tumor components (seminoma about 50% + immature teratoma about 25% + yolk sac tumor about 20% + embryonal carcinoma about 5%). Results The patient was admitted to hospital with“acute abdominal pain”,and the blood levels of AFP,HCG,and LDH were all elevated. Imaging examination showed space-occupying lesions in the abdominal cavity. The tumor and some surrounding tissues were surgically removed. After 6 months of follow-up, no tumor recurrence, and metastasis. Conclusion The treatment of mixed cryptorchidism germ cell tumor should be done as early as possible. Orchidopexy before the age of 2 can effectively reduce the occurrence of this disease. The treatment was radical resection combined with BEP (bleomycin, etoposide, cisplatin) chemotherapy. The prognosis varies according to the tumor components. The prognosis which contains choriocarcinoma is poor,while the seminoma is generally good.

Key words: cryptorchidism, mixed germ cell tumor, pathology, treatment, prognosis

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