The diagnosis and treatment of primary prostate synovial sarcoma (Report of 1 cases and literature reviewed)
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摘要: 目的:探讨前列腺滑膜肉瘤的影像学特点、临床病理和诊治方法。方法:对1例原发性前列腺滑膜肉瘤的临床诊治资料进行回顾性分析。该例患者行超声、CT、MRI检查。手术后病理证实(免疫组化)。结果:该患者行前列腺肿瘤根治性切除术。病理:镜下所见异型性细胞片状分布,免疫组化:CK34(+), CD99(+), Ki67(+),MYOD1(+/-),Actin(+),CD117(+),dog-1(+/-),Vimentin(+)。诊断原发性前列腺滑膜肉瘤随访6个月,患者存活。结论:原发性前列腺滑模肉瘤临床罕见,确诊依赖病理及免疫组化检查。应与梭形细胞肿瘤、恶性神经鞘瘤、横纹肌肉瘤、间质肉瘤鉴别。治疗以手术为主,需根据肿瘤分级分期决定手术方案及术后是否需行辅助治疗。
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关键词:
- 滑膜肉瘤 /
- 融合基因SYT-SSX /
- 前列腺滑膜肉瘤诊断和治疗
Abstract: Objective: To investigate the imaging characteristics, the clinical pathological features and the management of prostate synovial sarcoma. Method: One patient underwent primary prostate synovial sarcoma was observed and analyzed retrospectively. This patient was diagnosed with ultrasound、CT and MRI examination. The diagnosis was confirmed by pathological findings (immunohistochemical examination) after operation.Result: This patient underwent the radical prostatectomy. Pathological microscopically saw atypia cells patchy distribution. In Immunohistochemical essay:CK34(+),CD99(+),Ki67(+), MYOD1(+/-), Actin(+), CD117(+), dog-1(+/-), Vimentin(+).This patient was diagnosed as primary prostate synovial sarcoma. The patient was still alive for 6 months since the operation. Conclusion: primary prostate synovial sarcoma is an uncommon disease. Diagnosis depends on pathology and immunohistochemical examination. It should be identified with spindle cell tumors、Malignant schwannoma、Rhabdomyosarcoma and stromal sarcoma. Treatment is mainly by operation tumor grade and stage influence operation scheme decision and whether adjuvant therapy is required after operation. -
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[1] Iwasaki H, Ishiguro M, Ohjimi Y, et al. Synovial sarcoma of the prostate with t(X;18)(p11.2;q11.2)[J]. Am J Surg Pathol, 1999, 23:220-226.
[2] Shirakawa T, Fujisawa M, Gotoh A, et al. Complete resection of synovial sarcoma of prostatic fascia[J]. Urology, 2003, 61:644.
[3] Williams D H, Hua V N, Chowdhry A A, et al. Synovial sarcoma of the prostate[J]. J Urol, 2004, 171:2376.
[4] Pan C C, Chang Y H. Primary synovial sarcoma of the prostate[J]. Histopathology, 2006, 48:321-323.
[5] Porter H J 2nd, Damjanov I, Arnold P, et al. Synovial sarcoma metastatic to the penis and prostate[J]. J Urol, 2001, 166:605.
[6] 李君, 李燕园, 滕晓东, 等. 原发性前列腺滑膜肉瘤临床病理分析[J]. 中华病理学杂志, 2009, 38:479-480.
[7] Cheng Y C, Wang J H, Shen S H, et al. MRI findings of prostatic synovial sarcoma[J]. Br J Radiol, 2007, 80:e15-e18.
[8] 徐治宽, 杨堂斗, 吴秉铨, 等. 滑膜肉瘤的融合基因检测分析[J]. 中华病理学杂志, 2001, 30(6):431-433.
[9] Bixby S D, Hettmer S, Taylor G A, et al. Synovial sarcoma in children:imaging features and common benign mimics[J]. AJR Am J Roentgenol, 2010, 195:1026-1032.
[10] 杨文江, 夏同敬, 连业钦, 等. 滑膜肉瘤的影像学诊断及鉴别诊断[J]. 医学影像学杂志, 2010, 20(1):115-118.
[11] Alhazzani A R, El-Sharkawy M S, Hassan H. Primary retroperitoneal synovial sarcoma in CT and MRI[J]. Urol Ann, 2010, 2:39-41.
[12] 陈建宇, 刘庆余, 叶瑞心, 等. 滑膜肉瘤MRI影像特征与组织病理学的相关性研究[J]. 癌症, 2005, 24(1):87-90.
[13] Knösel T, Heretsch S, Altendorf-Hofmann A, et al. TLE1 is a robust diagnostic biomarker for synovial sarcomas and correlates with t(X;18):analysis of 319 cases[J]. Eur J Cancer, 2010, 46:1170-1176.
[14] Jagdis A, Rubin B P, Tubbs R R, et al. Prospective evaluation of TLE1 as a diagnostic immunohistochemical marker in synovial sarcoma[J]. Am J Surg Pathol, 2009, 33:1743-1751.
[15] 韩春荣, 孙燕, 韩秀萍, 等. Twist 和SnaiI在滑膜肉瘤中的表达[J]. 中国肿瘤临床, 2010, 37(24):1443-1446.
[16] 张如忠. 滑膜肉瘤的分子标记[J]. 实用肿瘤学杂志, 2002,17(4):279-282.
[17] 孙燕, 孙保存. 滑膜肉瘤的分子诊断进展[J]. 天津医科大学学报, 2009, 15(4):734-737.
[18] 阳兵, 张晓冬, 唐劲天, 等. 肿瘤纳米磁感应治疗技术发展现状[J]. 中国医疗器械信息, 2011, 18(10):37-41.
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