原发性精囊癌的诊断和治疗

摘要

Objective:To investigate the clinical characteristics,imaging features,diagnosis and treatment of pri-mary seminal vesicle carcinoma. Methods:Two cases of primary seminal vesicle carcinoma were reported and litera-tures were reviewed. Results:The CT scan of the 2 cases showed huge pelvic cystic neoplasm without the normal structure of seminal vesicle. One case was positive in seminal vesicle puncture biopsy guided by transrectal ultra-sound. Frozen section examination during excision of seminal vesicle neoplasm showed carcinoma whose origin was dif-ficult to identify. Both of them were treated by radical excision of urinary bladder,seminal vesicle and prostate. The fi-nal histopathological assessment confirmed that both of 2 cases had primary adenocarcinoma of the seminal vesicle. Both patients recovered smoothly after the operation and showed no recurrence and metastasis respectively during a 3 years follow - up and 6 months follow - up. Conclusion:Primary seminal vesicle carcinoma is rare and difficult to di-agnoze before operation,and it has diverse imaging manifestations. Surgery is considered the main treatment while the range of resection should be broad enough.%目的：探讨原发性精囊癌的临床表现、影像学特点和诊疗方法。方法：分析我科收治的2例原发性精囊癌，并结合文献进行复习。结果：2例患者术前经 CT 检查可见盆腔巨大囊性肿物，未见正常精囊结构。1例术前于超声引导下经直肠精囊穿刺活检确诊为精囊癌；另1例术中冰冻病理检查诊断为精囊癌。2例均于术中行膀胱、精囊、前列腺切除术，术后病理均诊断为精囊腺癌。患者术后恢复良好，分别随访3年及6个月，未见复发和转移。结论：原发性精囊癌临床罕见，术前诊断困难，最好的治疗方法是早期手术，切除范围应足够广泛。术后应定期随访，注意复发。