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罕见的支持细胞睾丸肿瘤的误导性特征病例报告。

Case Report of Misleading Features of a Rare Sertoli Cell Testicular Tumor.

机构信息

Vilnius City Clinical Hospital, Department of Urology, 10207 Vilnius, Lithuania.

National Center of Pathology, Affiliate of Vilnius University Hospital, 08406 Vilnius, Lithuania.

出版信息

Medicina (Kaunas). 2019 May 20;55(5):170. doi: 10.3390/medicina55050170.

Abstract

Testicular Sertoli cell tumors are extremely rare. Generally, they are benign neoplasms, which belong to a group called sex cord-stromal tumors. In this article, we present a case report of a Sertoli cell tumor, which was accidentally discovered during a urological consultation of a 42-year-old male. An ultrasound showed a 2.1 x 2.2 cm hypoechogenic, hypervascular tumor in the middle third of the left testicle. Serum tumor markers (α-fetoprotein, alkaline phosphatase, β-human chorionic gonadotropin, and lactic dehydrogenase) were all within the normal range. Rapid microscopic evaluation of fresh frozen sections during the operation was inconclusive, which led to a decision not to perform a radical orchiectomy immediately. On formalin-fixed paraffin-embedded (FFPE) sections, the tumor histology showed atypical patterns, and immunohistochemical analysis was performed in order to determine the type of neoplasm and differentiate it from other types of testicular tumors, so as to assign the further course of treatment. Radical inguinal orchiectomy was performed. The final pathology report showed a tumor with no predictive signs of aggressive behavior, which most closely resembled a Sertoli cell tumor.

摘要

睾丸支持细胞瘤极为罕见。一般来说,它们是良性肿瘤,属于称为性索-间质肿瘤的一组肿瘤。本文报道了 1 例偶然在 42 岁男性泌尿科就诊时发现的支持细胞瘤病例。超声显示左睾丸中三分之一处有一个 2.1x2.2cm 的低回声、富血管肿瘤。血清肿瘤标志物(甲胎蛋白、碱性磷酸酶、β-人绒毛膜促性腺激素和乳酸脱氢酶)均在正常范围内。术中快速冷冻切片的微观评估不明确,因此决定不立即进行根治性睾丸切除术。在福尔马林固定石蜡包埋(FFPE)切片中,肿瘤组织学显示出非典型模式,并进行了免疫组织化学分析,以确定肿瘤的类型并将其与其他类型的睾丸肿瘤区分开来,从而确定进一步的治疗方案。进行了根治性腹股沟睾丸切除术。最终的病理报告显示肿瘤没有侵袭性行为的预测迹象,最接近支持细胞瘤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ad7/6571665/740b2498ab38/medicina-55-00170-g001.jpg

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