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目的:报告罕见原发性附睾肉瘤1例,并讨论其临床特点及诊疗原则。方法:首次报告附睾肌源性间叶源性肉瘤1例,并检索复习文献。结果:患者22岁,自觉左侧睾丸增大1月余,B超提示左侧附睾尾5.5cm×4.2cm混合回声占位,择期行左侧附睾肿物切除术,术后病理报告示附睾低分化肌源性间叶源性肉瘤。随即行患侧睾丸高位切除术。术后2个月发现腹膜后多发淋巴结转移,术后6个月发现双肺转移。附睾肉瘤国内外文献共报道37例。结论:附睾肉瘤极为罕见,中老年常见,恶性程度较高,治疗以睾丸高位切除为主,预后较差。
Objective: To report a rare case of primary epididymal sarcoma and to discuss its clinical features and principles of diagnosis and treatment. Methods: The first report of epididymal myogenic sarcoma in 1 case, and retrieve the review of literature. Results: At the age of 22, the testicular left conscious more than a month later, B-ultrasound prompted the left epididymis tail 5.5cm × 4.2cm mixed echo occupancy, elective left epididymal resection, postoperative pathology report shows epididymal Differentiation of myogenic melanocytic sarcoma. Immediate line of ipsilateral testicular resection. Two months after operation, multiple retroperitoneal lymph node metastases were found, and bilateral lung metastases were found 6 months after operation. Epididymis sarcoma literature were reported in 37 cases. Conclusion: Epididymal sarcomas are extremely rare, common in middle-aged and elderly patients, and have a high degree of malignancy. The treatment is mainly of high testicular resection with poor prognosis.