Clinical Characteristics of a Testis-Associated Leiomyoma: A Case Report and Literature Review

睪丸連結平滑肌肉瘤之臨床表現：病例與分析

陳奕舟(Yih-Chou Chen) ； 李明勳(Ming-Hsun Li) ； 蔡維明(Wei-Min Tsai)

《臺灣泌尿科醫學會雜誌》 18卷3期 (2007/09) Pp. 157-160

摘要

平滑肌肉瘤為一種可於任何含平滑肌成份的器官長出的良性瘤，但很少長於泌尿生殖系統。在泌尿生殖系統中以於腎被膜最為常見，但於睪丸長出之平滑肌肉瘤則極為少見，目前由文獻整理出僅有十六位病例。本文報告第十七病例，為一名發現一年多無痛性陰囊腫塊之五十四歲男性。電腦斷層可見左側陰囊腫瘤但無明顯淋巴侵犯。血液生化檢查發現乙型人類絨毛膜激素及甲型胎兒蛋白均於正常值範圍內。經睪丸切除後發現為一顆鞘膜內具完整外膜之十乘八乘六公分大小的腫塊。病理組織切片發現為一平滑肌肉瘤，且其睪丸及副睪均未受侵犯。病人術後恢復良好並於手術後三日出院。
本文整理與探討所有十七個病例之臨床表現，鑑別診斷及組織侵犯。並建議使用「睪丸連結平滑肌肉瘤」這個名稱以便更精確地描述這一類疾病。

關鍵字

睪丸 ； 平滑肌肉瘤

並列摘要

Leiomyomas are benign lesions that can arise from any organ with a smooth muscle component, but they are infrequently found in the genitourinary tract. The renal capsule is the most common site of genitourinary tract involvement, but testis-associated leiomyomas are extremely rare with only 16 cases reported in the literature. Herein, we report the 17th case. This 54-year-old man suffered from a painless scrotal mass for 1 year. Computed tomography (CT) revealed a left scrotal tumor with no evidence of lymph node involvement. Biochemical data showed normal β-human chorionic gonadotropin (hCG) and α-fetoprotein levels. An orchiectomy was performed, and a 10×8×6-cm mass, encapsulated within the tunica vaginalis, was resected. The pathology revealed a leiomyoma with an intact testis and epididymis. His postoperative course was uneventful, and he was discharged 3 days after the surgery. Clinical presentations, differential diagnoses, and histological details were collectively reviewed for all 17 reported cases, and ”testis-associated leiomyoma” is proposed to precisely describe these lesions.

並列關鍵字

testis ； leiomyoma