Lioe T F, Biggart J D
Department of Pathology, Belfast City Hospital.
Br J Urol. 1993 May;71(5):600-6. doi: 10.1111/j.1464-410x.1993.tb16033.x.
A total of 85 patients with paratesticular tumours were diagnosed over a period of 36 years at this hospital; 66 patients (78%) had benign tumours, usually either an adenomatoid tumour or a lipoma. Of the remaining 19 malignant cases, 10 were primary neoplasms and 9 were metastases. A rare mucin-secreting epididymal adenocarcinoma was the only primary malignant epithelial tumour, the others being of mesenchymal origin. In 4/9 metastatic cases the initial presentation of a paratesticular swelling led to the discovery of the occult primary neoplasm following histological examination. Clinical features of a painful or painless mass, with or without an accompanying hydrocele, do not help to distinguish a benign from a malignant lesion. The prognosis of malignant tumours of mesenchymal origin depends mainly on the histological grade. Surgical resection remains the mainstay of treatment and adjuvant therapy significantly improves the chances of survival only in young patients with paratesticular rhabdomyosarcomas. Older patients with high grade tumours usually succumb to their disease despite chemotherapy and/or radiotherapy.
在这家医院的36年期间，共诊断出85例睾丸旁肿瘤患者；66例（78%）患有良性肿瘤，通常为腺瘤样瘤或脂肪瘤。其余19例恶性病例中，10例为原发性肿瘤，9例为转移瘤。一种罕见的分泌黏液的附睾腺癌是唯一的原发性恶性上皮性肿瘤，其他为间叶组织来源。在9例转移瘤病例中的4例中，睾丸旁肿块的最初表现导致在组织学检查后发现隐匿性原发性肿瘤。疼痛或无痛性肿块的临床特征，无论是否伴有鞘膜积液，都无助于区分良性和恶性病变。间叶组织来源的恶性肿瘤的预后主要取决于组织学分级。手术切除仍然是主要的治疗方法，辅助治疗仅在患有睾丸旁横纹肌肉瘤的年轻患者中显著提高生存机会。老年高级别肿瘤患者通常尽管接受了化疗和/或放疗，仍会死于疾病。
