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患者,男性,48岁,双侧阴囊疼痛1月余,右侧稍重。体检:阴囊无明显红肿,右侧附睾头部及左侧附睾体部皆可扪及圆形结节。右侧附睾头部结节大小约1cm×0.6cm×0.6cm,左侧体部结节大小约0.5cm×0.4cm×0.5cm,触痛明显。初步诊断为慢性附睾炎(双侧),行抗炎治疗1个月,效果不佳,因痛疼症状明显,先后在局麻下行左、右附睾切除术。术中见右侧附睾头部、左侧附睾体部分别有一圓形结节,质地较硬,与附睾分界欠清,表面有包膜。将肿物及附睾完整切除送病理检查,镜下见肿物边界清楚,由呈旋涡状及编织状的瘤细胞聚集而成,血管增多,管壁增厚,血管壁平滑肌细胞与周围瘤细胞有移行现象。病理诊断;右附睾头部、左附睾体部血管平滑肌瘤。
Patient, male, 48 years old, bilateral scrotal pain more than 1 month, the right slightly heavier. Physical examination: no obvious redness of the scrotum, the right epididymis and left epididymis body palpable circular nodules. Right epididymis nodules size of about 1cm × 0.6cm × 0.6cm, the size of the left nodule about 0.5cm × 0.4cm × 0.5cm, tenderness significantly. Initial diagnosis of chronic epididymitis (bilateral), the line of anti-inflammatory treatment for 1 month, the effect is not good, because the obvious pain and symptoms, has undergone local anesthesia left and right epididymal resection. See the right epididymal surgery in the surgery, the left epididymis were respectively a circular nodules, texture hard, and epididymal demarcation less clear, the surface of the capsule. The tumor and epididymis complete resection sent to pathological examination, the tumor was clearly seen under the microscope, the tumor was swollen and braided cells gathered, increased blood vessels, wall thickening, vascular wall smooth muscle cells and surrounding tumor cells have Migration phenomenon. Pathological diagnosis; right epididymis, left epididymis body vascular smooth muscle tumor.