【摘要】 目的探讨原发性精囊腺癌的临床表现、影像学特点及诊治方法。方法分析收治的原发性精囊腺癌患者2例,其中1例合并巨大多分隔精囊囊肿,并结合文献进行复习。结果 1例术前行前列腺穿刺活检阴性,行前列腺电切术后病理证实为偶发癌,2个月后二期行开放前列腺癌根治术后确诊为精囊癌;另一例术前经CT及经直肠超声可见盆腔巨大囊性多分隔肿物,未见正常前列腺及精囊结构,代之以多房囊肿,行腹腔镜下盆腔囊肿切除术,术中冰冻病理诊断为精囊癌,转行开放性前列腺根治术。两例术后恢复良好,分别随访10年及7个月,未见复发转移。结论原发性精囊腺癌临床罕见,术前诊断较困难,影像学表现大致可分为3类,手术为主要治疗方式,切除范围应足够广泛。更多还原

【Abstract】 Objective To discuss the clinical manifestation,imaging features,diagnosis and treatment of primary seminal vesicle carcinoma(SCVA).Methods Two cases of SCVA were reported and literature was reviewed.One case was complicated with huge multi-separated cyst.Results One case was negative in prostate biopsy.The pathological diagnosis after transurethral resection of prostate confirmed it was incidental carcinoma,which was then proved to be SVCA by a secondary radical prostatectomy 2 months later.For the other case,in the area of seminal vesicle transrectal ultrasound retrograde urethrography and CT showed neither regular prostate or seminal vesicle structure,which were replaced by multilocular cysts.Frozen section examination during laparoscopic excision of seminal vesicle neoplasm showed carcinoma whose origin was difficult to identify. Then a radical prostatectomy was performed,and the pathological diagnosis was proven to be SVCA.Both patients recovered smoothly after the operation and showed no recurrence and metastasis respectively during a10 years follow-up and a 7 months follow-up.Conclusions SVCA is rare and difficult to diagnose before operation,and it has diverse imaging manifestations. Surgery is considered the main treatment while the range of resection should be broad enough.更多还原