Heidenreich A, Engelmann U H, Vietsch H V, Derschum W
Department of Urology, University of Cologne, Germany.
J Urol. 1995 Apr;153(4):1147-50.
Our experience with 18 patients with simple epidermoid cysts of the testis (monodermal teratoma) is reported. In all patients the tumor was enucleated completely and 2 biopsies of the adjacent parenchyma were obtained for exclusion of associated germ cell cancer, scar or carcinoma in situ. There was no evidence of malignancy in any biopsy specimen. Preoperative evaluation included physical examination, testicular sonography, and determination of alpha-fetoprotein and beta-human chorionic gonadotropin levels. Although epidermoid cyst was strongly suggested by sonography, the ultrasonic appearance was not specific and inguinal testicular exploration was required. In 1 patient multiple epidermoid cysts of the right testis were associated with an adult teratoma containing embryonal carcinoma and choriocarcinoma of the left testicle. To our knowledge no similar case has been described in the literature. Based on our results and our experience, we consider tumor enucleation and biopsy of the adjacent parenchyma as adequate treatment for the benign epidermoid cyst. The literature concerning organ sparing surgery in testicular epidermoid cysts is reviewed.
本文报告了我们对18例睾丸单纯表皮样囊肿（单胚层畸胎瘤）患者的治疗经验。所有患者的肿瘤均被完整摘除，并获取了相邻实质组织的两份活检样本，以排除相关的生殖细胞癌、瘢痕或原位癌。所有活检标本均未发现恶性证据。术前评估包括体格检查、睾丸超声检查以及甲胎蛋白和β-人绒毛膜促性腺激素水平的测定。尽管超声检查强烈提示为表皮样囊肿，但其超声表现并不具有特异性，仍需进行腹股沟睾丸探查。1例患者右侧睾丸的多个表皮样囊肿与左侧睾丸的成人畸胎瘤合并胚胎癌和绒毛膜癌相关。据我们所知，文献中尚未描述过类似病例。基于我们的研究结果和经验，我们认为肿瘤摘除及相邻实质组织活检是治疗良性表皮样囊肿的适当方法。本文还对有关睾丸表皮样囊肿保留器官手术的文献进行了综述。
