Department of Urology, The First Clinical Medical College of China Three Gorges University, Yichang Central People's Hospital, Yichang, China.
Department of Pharmacy, The Second Clinical Medical College of China Three Gorges University, Three Gorges University Renhe Hospital, Yichang, China.
J Med Case Rep. 2024 Jun 10;18(1):274. doi: 10.1186/s13256-024-04590-4.
Epididymal tumors, especially malignant tumors, have low incidence and are rare in our clinical work. However, they may progress quickly and have poor prognosis. For such rare clinical cases with extremely low incidence rates, and as they are prone to misdiagnosis and missed diagnosis and have a very poor prognosis, clinical workers need to pay special attention and consider the possibility of primary epididymal malignant tumors.
A 63-year-old Chinese male patient from Asia was admitted due to scrotal pain. Upon examination, an abnormal lesion was found in the right epididymal region. After thorough evaluation, surgical resection was performed, and the postoperative pathological result confirmed the presence of epididymal adenocarcinoma. After further ruling out secondary lesions, primary epididymal adenocarcinoma was considered. Right retroperitoneal lymph node dissection was performed under laparoscopic for treatment, and 1/11 lymph node metastasis was detected after surgery. The patient is currently under close follow-up.
The number of clinical cases of primary epididymal malignant tumors is very limited, there is currently no standardized diagnosis and treatment process, and there is a lack of systematic evaluation methods regarding the effectiveness of different treatment options such as chemotherapy, radiotherapy, immunotherapy, and targeted therapy. In addition, the outcome is difficult to predict. In this article, we reviewed relevant literature and systematically elaborated on the diagnosis and treatment of epididymal malignant tumors, hoping to provide useful information for relevant experts.
附睾肿瘤，尤其是恶性肿瘤，发病率低，在临床工作中少见。但进展快，预后差。对于此类罕见的发病率极低的临床病例，极易误诊、漏诊，且预后极差，临床工作者需要特别关注，考虑原发性附睾恶性肿瘤的可能。
一名来自亚洲的 63 岁中国男性患者因阴囊疼痛就诊。检查发现右侧附睾区有异常病变。经全面评估后，行手术切除，术后病理结果证实为附睾腺癌。进一步排除继发肿瘤后，考虑为原发性附睾腺癌。行腹腔镜下右侧腹膜后淋巴结清扫术治疗，术后发现 1/11 枚淋巴结转移。目前患者正在密切随访中。
原发性附睾恶性肿瘤的临床病例数量非常有限，目前尚无标准化的诊断和治疗流程，对于化疗、放疗、免疫治疗、靶向治疗等不同治疗方案的有效性也缺乏系统的评价方法。此外，预后难以预测。本文复习相关文献，对附睾恶性肿瘤的诊治进行了系统阐述，希望为相关专家提供有用信息。
