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目的报告3例前列腺肉瘤的病例,结合文献回顾分析其临床特点,探讨前列腺肉瘤的诊断和治疗。方法复习病案,分别为青年、中年和老年男性,病理分别为前列腺横纹肌肉瘤、平滑肌肉瘤和纤维肉瘤。PSA介于0．4ng/ml到1．5ng/ml之间。术前CT均诊断为前列腺恶性肿瘤,确诊则采用经直肠超声引导下的前列腺穿刺活检。本文3例前列腺肉瘤中,1例采用规律VAC化疗；1例术前给予VAC新辅助化疗后行前列腺根治切除术；术后继续辅助VAC化疗。结果1例前列腺恶性纤维组织肉瘤的患者放弃治疗,半年后死亡。1例前列腺横纹肌肉瘤后前列腺体积明显缩小,于确诊10个月后发现肝转移、肺转移而死亡。1例前列腺平滑肌肉瘤行“前列腺根治性切除术”,术前、术后均给予VAC方案化疗,术后5个月发现肿瘤复发,术后1年死亡。结论前列腺肉瘤患者生存率的提高有赖于早期诊断和根治性切除,而新型放疗和化疗的应用,有助于改善患者的预后。
Objective To report the cases of prostate sarcoma in 3 cases and to review the clinical features of the literature and to discuss the diagnosis and treatment of prostate sarcoma. Methods to review the medical record, respectively, young, middle-aged and older men, the pathology of the prostate rhabdomyosarcoma, leiomyosarcoma and fibrosarcoma. PSA is between 0.4 ng / ml and 1.5 ng / ml. Preoperative CT were diagnosed as prostate cancer, diagnosed by transrectal ultrasound guided prostate biopsy. In this paper, 3 cases of prostate sarcoma, 1 case of regular VAC chemotherapy; 1 case of preoperative VAC neoadjuvant chemotherapy after radical prostatectomy; continue to assist VAC chemotherapy. Results One patient with benign prostatic malignant fibrous sarcoma was abandoned and died after six months. One case of prostate rhabdomyosarcoma after prostate volume was significantly reduced, 10 months after the diagnosis of liver metastasis, lung metastasis and death. One patient with benign prostatic leiomyosarcoma underwent radical prostatectomy. VAC regimen was given preoperatively and postoperatively. Tumor recurrence was found 5 months after operation and died 1 year after operation. Conclusion The improvement of survival rate in patients with prostate sarcoma depends on early diagnosis and radical resection. The application of new radiotherapy and chemotherapy can improve the prognosis of patients.