论文部分内容阅读
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 explore the origin, diagnosis and treatment of primary neuroendocrine carcinoma of the testis and to raise awareness of the disease. Methods: One case of primary neuroendocrine carcinoma in our hospital was retrospectively analyzed and the related literatures were reviewed. Results: There was a painful mass in the left testis of the patient, hard. Color Doppler scan confirmed that there was a 2.7 cm × 2.3 cm × 3.1 cm hypoechoic mass in the left testes. The envelopment was complete and the boundaries were clear. The signal of blood flow in the mass was rich. No enlarged lymph nodes were seen after retroperitoneal and groin ultrasound examination. Serum tumor markers β-HCG, CEA and AFP showed no abnormalities. Surgical complete resection of the tumor, postoperative pathological examination for testicular neuroendocrine cancer. Lesions originated in neuroendocrine cells, cancer-like round, cytoplasmic Eosin staining, nuclear round, granular, cancer cells nested or island-like arrangement. The cancer cells diffusely express synaptophysin, Chromogranin A and cytokeratin. Conclusion: The primary neuroendocrine carcinoma of the testis is rare, its clinical manifestations are lack of specificity, histological features and immunohistochemical markers are the main basis for the diagnosis of the disease, and need to be differentiated from metastatic carcinoids and mixed carcinoids. Early diagnosis and surgery with good results, should be followed up after surgery to prevent recurrence and metastasis.