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[术前影像学诊断在精索脂肪肉瘤中的应用价值]

[Utility of pre-operative imaging diagnosis in spermatic cord liposarcoma].

作者信息

Isoyama R, Shirataki S, Takihara H, Sakatoku J

机构信息

Department of Urology, Yamaguchi University School of Medicine.

出版信息

Hinyokika Kiyo. 1990 Jun;36(6):721-4.

PMID:2239568
Abstract

A case of spermatic cord liposarcoma was revealed by imaging diagnosis. The patient was a 59-year-old male, who consulted our clinic with the complaint of painless right scrotal swelling on June 30, 1989. One year earlier, he noticed this swelling, which was slow growing little by little. Palpation revealed a movable mass in right scrotum, 7 x 3 x 3 cm in size and separated from the right testis. Scintigraphy could not show RI accumulation and ultrasonography showed a capsulated homogeneous mass. Computed tomography (CT) and magnetic resonance imaging (MRI) showed capsulated fat-like almost homogeneous mass, which enclosed the right spermatic cord. This mass was suspected of spermatic cord lipoma or liposarcoma and was removed with radical orchiectomy. The weight of the mass was 246 g. This mass had a bunch of grape appearance and consisted of several masses of various sizes surrounding the spermatic cord, and could be separated from the right epididymis and testis. Histological examination revealed well differentiated liposarcoma and lipoma. Spermatic cord liposarcoma is very rare and this preoperative diagnosis is very difficult. Imaging diagnosis, such as CT, MRI may help our preoperative diagnosis.

摘要

一例精索脂肪肉瘤经影像学诊断得以揭示。患者为一名59岁男性,于1989年6月30日因右侧阴囊无痛性肿胀前来我院就诊。一年前,他注意到这种肿胀,且肿胀在逐渐缓慢增大。触诊发现右侧阴囊内有一可活动肿物,大小为7×3×3厘米,与右侧睾丸分离。闪烁扫描未显示放射性核素积聚,超声检查显示为一有包膜的均匀肿物。计算机断层扫描(CT)和磁共振成像(MRI)显示为有包膜的、几乎均匀的脂肪样肿物,包绕右侧精索。该肿物怀疑为精索脂肪瘤或脂肪肉瘤,遂行根治性睾丸切除术将其切除。肿物重量为246克。该肿物呈葡萄串样外观,由围绕精索的多个大小各异的肿物组成,可与右侧附睾和睾丸分离。组织学检查显示为高分化脂肪肉瘤和脂肪瘤。精索脂肪肉瘤非常罕见,术前诊断极为困难。CT、MRI等影像学诊断可能有助于我们进行术前诊断。

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