Philip Joe, Manikandan Ramaswamy, Vishwanathan Palaniswamy, Mathew Joseph
Department of Urology, Royal Cornwall Hospital, Truro, UK.
J Med Case Rep. 2008 Sep 9;2:295. doi: 10.1186/1752-1947-2-295.
Scrotal leiomyomas are rare tumours which are essentially benign. Recurrence and malignant transformation to leiomyosarcoma have been reported. However, a specific subgroup with increased bizarre nuclei showing increased mitosis raises the need for a closer follow-up. We report on such a case.
We report the case of a 65-year-old man who underwent a scrotal lump excision. Histology showed a well defined leiomyoma. The presence of nuclear pleomorphism and mitoses, just falling short of the criteria for malignancy, made prediction of biological behaviour difficult. The patient remains well on 4-year follow-up.
Histological evidence of increased mitosis raises the need for sustained follow-up in view of the malignant potential from the extent of mitosis. Immunohistochemistry helps in identifying those patients warranting close follow-up.
阴囊平滑肌瘤是一种罕见的肿瘤，本质上为良性。已有复发及恶变至平滑肌肉瘤的相关报道。然而，存在一个具有增多的奇异核且有丝分裂增加的特定亚组，这就需要更密切的随访。我们报告这样一例病例。
我们报告一名65岁男性阴囊肿块切除病例。组织学检查显示为边界清晰的平滑肌瘤。存在核异形性和有丝分裂，但未达到恶性标准，这使得生物学行为的预测变得困难。该患者在4年随访期内情况良好。
鉴于有丝分裂程度所提示的恶性潜能，有丝分裂增加的组织学证据表明需要持续随访。免疫组化有助于识别那些需要密切随访的患者。
