Ali Y, Kehinde E O, Makar R, Al-Awadi K A, Anim J T
Department of Surgery (Urology Division), Mubarak Al-Kabir Hospital and Faculty of Medicine, Kuwait University, Kuwait.
Med Princ Pract. 2002 Jul-Sep;11(3):157-60. doi: 10.1159/000063239.
To report on a case of leiomyosarcoma of the testis that appeared to have arisen from a background of chronic testicular inflammation.
A 65-year-old man with a 15-year history of diabetes mellitus and low-grade discomfort and swelling in the right testis presented as an emergency with exacerbation of the pain and swelling of the testis. Repeated ultrasound examination of the testis in the past 5 years had suggested a chronic testicular inflammatory disorder. Ultrasound during the current emergency case admission revealed a normal left testis, but a large heterogeneous solid mass with a moderate intratesticular calcification in the right testis and the presence of a moderate hydrocele. Serum alpha-fetoprotein and beta-human chorionic gonadotropin were normal. A right radical orchidectomy was performed. Histopathology and immunohistochemistry revealed primary leiomyosarcoma of the right testis. There was no spermatic cord or venous involvement. One year after orchidectomy there was no sign of metastasis.
Radical orchidectomy followed by surveillance appears to be the treatment of choice for this testicular leiomyosarcoma, which seemed to have run an indolent course compared to other testicular tumours.
报告一例睾丸平滑肌肉瘤病例，该病例似乎起源于慢性睾丸炎症背景。
一名65岁男性，有15年糖尿病病史，右侧睾丸有低度不适和肿胀，因睾丸疼痛和肿胀加剧而急诊入院。在过去5年中，对该睾丸进行的多次超声检查提示存在慢性睾丸炎症性疾病。本次急诊入院时的超声检查显示左侧睾丸正常，但右侧睾丸有一个大的异质性实性肿块，伴有中度睾丸内钙化，并有中度鞘膜积液。血清甲胎蛋白和β-人绒毛膜促性腺激素正常。遂行右侧根治性睾丸切除术。组织病理学和免疫组织化学检查显示为右侧睾丸原发性平滑肌肉瘤。精索和静脉未受累。睾丸切除术后一年无转移迹象。
根治性睾丸切除术后进行监测似乎是该睾丸平滑肌肉瘤的首选治疗方法，与其他睾丸肿瘤相比，该肿瘤的病程似乎较为隐匿。
