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目的 探讨睾丸混合性生殖细胞肿瘤(TMGCT)的临床病理特征、诊断、治疗及预后。方法 回顾性分析7例TMGCT患者的临床资料、组织病理学形态、免疫组化表达及随访情况，并复习相关文献。结果 7例患者年龄23～45岁，平均年龄35岁。主要表现为睾丸肿大，2例伴疼痛，2例有睾丸外伤史。大体检查肿瘤大多单发，左侧为主，最大径为2.0～10.0 cm,切面呈灰白色、灰黄色或灰褐色，实性或囊实性。组织学表现为肿瘤细胞结构及形态多样，以不同种类及比例混合，包括6例胚胎性癌，5例精原细胞瘤，5例卵黄囊瘤，4例畸胎瘤，3例绒毛膜癌，2例侵犯脉管，1例侵犯附睾。随访12个月～178个月，2例失访，5例获得随访，治疗均行根治性睾丸切除术及术后化疗，均存活，除1例肺转移外，其余患者均无复发和转移。结论 TMGCT是一种少见的睾丸恶性肿瘤，其生物学行为和预后与组织学类型有关，免疫组化标记对病理诊断与鉴别诊断具有重要作用。
Abstract：Objective To investigate the clinicopathological features, diagnosis, treatment and prognosis of testicular mixed germ cell tumors(TMGCT). Methods We retrospectively analyzed the clinical data, histopathological morphology, immunohistochemical expression and follow-up of 7 patients with TMGCT, and reviewed the relevant literatures. Results The 7 patients ranged in age from 23 to 45 years, with an average age of 35 years. The main manifestations were testicular enlargement, with pain in 2 cases, and a history of testicular trauma in 2 cases. Most of the tumors in gross examination were solitary, predominantly on the left side, with a maximum diameter of 2.0-10.0 cm, and the sections were grayish-white, grayish-yellow or grayish-brown, solid or cystic solid. The tumor cells had diverse structures and morphologies, mixed in different types and proportions, including 6 cases of embryonal carcinoma, 5 cases of seminoma, 5 cases of yolk sac tumor, 4 cases of teratoma, 3 cases of choriocarcinoma, 2 cases had lymphovascular invasion, and 1 case involving the epididymis. All patients underwent radical orchiectomy and postoperative chemotherapy, 2 cases were lost to follow-up, and 5 cases were followed up for 12 months to 178 months, all of whom survived. Except for 1 case with lung metastasis, the other patients had no recurrence or metastasis. Conclusion TMGCT is an uncommon malignant tumor of the testis. Its biological behavior and prognosis are related to the histological type. Immunohistochemical markers play an important role in pathological diagnosis and differential diagnosis.
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中图分类号:R737.21
引用信息:
[1]吴敏,左春霞,谢建兰等.睾丸混合性生殖细胞肿瘤临床病理分析并文献复习[J].诊断病理学杂志,2024,31(12):1136-1140.
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