Frey P, Fliegel C, Herzog B
Department of Paediatric Surgery, University Children's Hospital, Basel, Switzerland.
Z Kinderchir. 1990 Aug;45(4):229-34. doi: 10.1055/s-2008-1042588.
Between 1961 and 1989 twenty testicular tumours were treated at the Basel University Children's Hospital. Ten were non germ cell tumours (50%) and a further 10 (50%) were germ cell tumours. Of the germ cell tumours six were benign teratomas, two yolk sac tumours and a further two were teratocarcinomas. In the non germ cell group eight tumours originated from paratesticular structures, one of which was a malignant rhabdomyosarcoma. The remaining two neoplasms originated from the supporting testicular tissues. The clinical presentation, the protocol of treatment and the long-term outcome are discussed. We advocate local tumour excision in benign cases (proven by instant frozen section) if normal testicular tissue can be preserved. In malignant germ cell tumours primary orchiectomy and high spermatic cord ligation is the treatment of choice. Secondary chemotherapy and/or retroperitoneal lymph node dissection is only added if the tumour markers alpha-fetoprotein and beta-human chorionic gonadotropin remain present in high serum levels postoperatively. Rhabdomyosarcomas are treated by surgical excision, primary chemotherapy and radiotherapy. All of the five patients (25%) suffering from malignant testicular tumours survived. A long-term follow-up (mean 12 years) did not show any evidence of recurrent local or metastatic disease.
1961年至1989年间，巴塞尔大学儿童医院共治疗了20例睾丸肿瘤。其中10例为非生殖细胞肿瘤（50%），另外10例（50%）为生殖细胞肿瘤。生殖细胞肿瘤中，6例为良性畸胎瘤，2例为卵黄囊瘤，另有2例为畸胎癌。非生殖细胞肿瘤组中，8例肿瘤起源于睾丸旁结构，其中1例为恶性横纹肌肉瘤。其余2例肿瘤起源于睾丸支持组织。本文讨论了临床表现、治疗方案及长期预后。对于良性病例（经术中冰冻切片证实），若能保留正常睾丸组织，我们主张行局部肿瘤切除术。对于恶性生殖细胞肿瘤，首选治疗方法是根治性睾丸切除术及高位精索结扎术。仅在术后血清中甲胎蛋白和β-人绒毛膜促性腺激素肿瘤标志物仍处于高水平时，才追加辅助化疗和/或腹膜后淋巴结清扫术。横纹肌肉瘤采用手术切除、术前化疗及放疗进行治疗。5例（25%）恶性睾丸肿瘤患者均存活。长期随访（平均12年）未发现局部复发或远处转移的迹象。
