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精囊原发性梭形细胞肉瘤:病例报告及文献复习。

Primary spindle cell sarcoma of the seminal vesicle: A case report and literature review.

机构信息

Department of Urology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.

Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.

出版信息

Andrologia. 2022 May;54(4):e14363. doi: 10.1111/and.14363. Epub 2022 Jan 5.

Abstract

We report a case of primary seminal vesicle spindle cell sarcoma of a 57-year-old man who underwent multiple surgical treatment. The first diagnosis of a local hospital was a right seminal vesicle cyst, so only laparoscopic decompression was performed. Postoperatively, the patient gradually developed lower abdominal discomfort, frequent and urgent urination, dysuria and constipation. Digital rectal examination palpated a heterogeneous mass. Magnetic resonance imaging showed a multilocular cystic mass of about 4.5 cm in diameter in the right seminal vesicle, which was diagnosed as a recurrent cyst. The patient underwent a second operation in our hospital, but the tumour could not be completely removed because of severe peripheral adhesions. The postoperative pathological diagnosis was seminal vesicle cystadenoma with spindle cell sarcoma. One month later, a computed tomography scan performed at another hospital showed that the mass had invaded the bladder and sigmoid colon. The pathological diagnosis of re-examination was spindle cell liposarcoma. After neoadjuvant chemotherapy, extended resection of the tumour was performed, and adjuvant chemotherapy was continued after surgery. The total duration of follow-up was 19 months and 3 months after the third surgery. The patient survived with no recurrence or metastasis.

摘要

我们报告了一例 57 岁男性原发性精囊梭形细胞肉瘤病例,该患者接受了多次手术治疗。当地医院的首次诊断为右侧精囊囊肿,因此仅行腹腔镜减压术。术后,患者逐渐出现下腹部不适、尿频、尿急、排尿困难和便秘。直肠指检触及不均匀肿块。磁共振成像显示右侧精囊内约 4.5cm 直径的多房囊性肿块,诊断为复发性囊肿。患者在我院行第二次手术,但由于严重的周围粘连,肿瘤无法完全切除。术后病理诊断为精囊囊腺瘤伴梭形细胞肉瘤。一个月后,另一家医院的 CT 扫描显示肿块已侵犯膀胱和乙状结肠。再次检查的病理诊断为梭形细胞脂肪肉瘤。新辅助化疗后,行肿瘤扩大切除术,术后继续辅助化疗。总随访时间为 19 个月,第三次手术后 3 个月。患者存活,无复发或转移。

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