Wei Yi, Wu Shengde, Lin Tao, He Dawei, Li Xuliang, Liu Junhong, Liu Xing, Hua Yi, Lu Peng, Wei Guanghui
Ministry of Education Key Laboratory of Child Development and Disorders; Key Laboratory of Pediatrics in Chongqing, CSTC2009CA5002; Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Room 806, Kejiao Building (NO,6 Building), No,136, 2nd Zhongshan Road, Chongqing City, Yuzhong District, China.
World J Surg Oncol. 2014 Dec 29;12:400. doi: 10.1186/1477-7819-12-400.
To describe 19 years of clinical experience managing pediatric patients with testicular yolk sac tumors at the Chongqing Medical University Affiliated Children's Hospital.
This study involved a retrospective review of the records of 61 pediatric patients who presented with testicular yolk sac tumor at our institution between 1995 and 2014.
All patients presented with a painless scrotal mass. Serum alpha-fetoprotein (AFP) levels were elevated (n = 15). Ultrasonography identified the yolk sac tumors as solid masses. Color Doppler flow imaging showed rich blood flow inside and around the masses in 84.8% cases. X-ray of the scrotum showed no intrascrotal calcification (n = 38). Inguinal orchiectomy was performed in 60 patients, one case was treated with testis-sparing surgery. In 11 cases, radical dissection of the inguinal lymph nodes was performed. Histological analysis showed pathologies typical of yolk sac tumor including microcapsule and reticular structures, gland tube-gland bubble structures, an embryo sinus structure, and papillary structures. All patients received postoperative chemotherapy. Serum AFP levels returned to normal 1 to 2 months after surgery. No patients treated with surgery in our hospital relapsed.
Testicular yolk sac tumor presents as a painless scrotal mass, increased serum AFP levels, and a solid mass on ultrasound. Chest radiography and abdominal ultrasound should be used to accurately stage the tumor. We advocate for inguinal orchiectomy for Stage I disease and postoperative chemotherapy to prevent recurrence in the ipsilateral or contralateral testis.
描述重庆医科大学附属儿童医院19年来治疗小儿睾丸卵黄囊瘤的临床经验。
本研究回顾性分析了1995年至2014年间我院收治的61例小儿睾丸卵黄囊瘤患者的病历。
所有患者均表现为无痛性阴囊肿块。血清甲胎蛋白（AFP）水平升高（n = 15）。超声检查将卵黄囊瘤识别为实性肿块。彩色多普勒血流成像显示84.8%的病例肿块内部及周围血流丰富。阴囊X线检查未发现阴囊内钙化（n = 38）。60例行腹股沟睾丸切除术，1例行保留睾丸手术。11例行腹股沟淋巴结根治性清扫术。组织学分析显示卵黄囊瘤的典型病理表现，包括微囊和网状结构、腺管-腺泡结构、胚胎窦结构和乳头结构。所有患者术后均接受化疗。术后1至2个月血清AFP水平恢复正常。我院接受手术治疗的患者均未复发。
睾丸卵黄囊瘤表现为无痛性阴囊肿块、血清AFP水平升高及超声下实性肿块。应采用胸部X线和腹部超声准确分期肿瘤。对于I期疾病，我们主张行腹股沟睾丸切除术及术后化疗，以预防同侧或对侧睾丸复发。
