Objective To investigate the clinical features, diagnosis, treatment and prognosis of adult testicular teratoma. Methods Clinical data of three patients with adult testicular teratoma were retrospectively analyzed from the June, 2014 to June, 2016.The mean age was 24 years old, ranging 22 to 28 years old. Color Doppler echocardiography examination showed round or oval regular tumors in the scrotum with the diameter from 1.6 to 10 cm, mean 5.6 cm, but abdomen and pelvic cavity CT analysis demonstrated no abnormal changes. Testosterone levels and semen indicators of three patients were normal. Levels of serum AFP and beta hCG in two patients were normal, whereas that of the other one elevated. One patient received tumor resection with retained testicular, and the others underwent radical orchiectomy. Results Operations for three patients were completed successfully. The mean operation time was 62 minutes, ranging from 45 to 80 minutes. One case was pathologically diagnosed as dermoid cyst, one case as maturity teratoma, and other one as teratoma with somatic cell malignancy. Two cases received postoperative chemotherapy. After 12 to 36 months postoperative follow-up, all 3 cases survived, and their postoperative testosterone levels, AFP level, β-hCG level, semen indicators were all normal, 2 cases had no tumor recurrence and metastasis, but one case had high level of AFP, β-hCG, and retroperitoneal tumor occurred in 6 months after surgery. Conclusion Adult testicular teratoma and testicular dermoid cyst are rare in clinic. Postpubertal-type testicular teratoma with malignant behavior should receive testes radical resection as early as possible, prepubertal-typle may underwent tumor resection with retained testicular. Type of tumor tissues and pathological staging determine the prognosis of adult testicular teratoma.%目的 探讨成人睾丸畸胎瘤的临床特点、诊治方法及预后.方法 回顾性分析我院2014年6月至2016年6月收治的3例成人睾丸畸胎瘤患者的临床资料,年龄22～28岁,平均24岁.术前阴囊彩色多普勒超声检查示睾丸肿瘤直径1.6～10.0cm,平均5.6cm.3例腹盆腔CT检查均未见异常.3例睾酮水平、精液指标均正常,2例肿瘤标记物AFP、β-hCG均正常,1例升高.1例行保留睾丸的肿瘤切除术;2例行根治性睾丸切除术.结果 3例手术均顺利完成,手术时间45～80min,平均62min.术后病理诊断1例为皮样囊肿,1例为成熟性畸胎瘤,1例为伴有体细胞恶性成分的畸胎瘤.2例术后接受化疗.术后随访12～36个月,平均21个月,3例均存活;3例术后睾酮水平、AFP、β-hCG、精液指标均正常;2例未见肿瘤复发和转移,1例术后6月AFP、β-hCG升高,发现腹膜后肿瘤复发.结论 成人睾丸畸胎瘤临床少见,睾丸皮样囊肿则为罕见.青春期后型睾丸畸胎瘤有恶性行为,应尽早行睾丸根治性切除术,青春期前型可选择保留睾丸的手术.成人睾丸畸胎瘤的预后取决于肿瘤组织类型和病理分期.
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