目的

探讨精索去分化脂肪肉瘤临床病理特点，诊断与鉴别诊断，治疗及预后。

方法

对在郑州大学第一附属医院确诊的2例精索去分化脂肪肉瘤患者的临床资料进行回顾性分析并对相关文献进行复习总结。

结果

两例患者均表现为右侧腹股沟肿物。病例1行腹股沟病损及右侧睾丸根治性切除术，目前随访6个月，未见复发。病例2就诊于当地卫生院，行肿物活检术，我院病理确诊后未做进一步治疗，目前随访1年，发现局部进展。

结论

精索去分化脂肪肉瘤罕见，常表现为一侧腹股沟无痛性肿物或一侧阴囊异常增大，术前详细的体格检查及影像学检查十分必要，需结合组织病理学、免疫组化、基因检测确诊。手术切除是首选治疗方案，必要时可辅以放化疗、分子靶向治疗，根治性切除术后应密切随访。

Objective

To investigate the clinicopathologic features，diagnosis，differential diagnosis，treatment and prognosis of dedifferentiated liposarcoma of spermatic cord.

Methods

The clinical data of two patients with dedifferentiated liposarcoma of spermatic cord diagnosed in the First Affiliated Hospital of Zhengzhou Universitywere retrospectively analyzed and the related literature was reviewed.

Results

Both patients presented with right groin masses. Case 1 underwent excision of groin lesion and radical excision of right testicle. No recurrence was observed during 6 months'follow-up. Case 2 was admitted to a local health center for tumor biopsy，but no further treatment was given after pathological diagnosis in our hospital. At present，one year follow-up has been conducted and local progress has been found.

Conclusions

Dedifferentiated liposarcoma of spermatic cord is rare and often presents as painless mass in one groin or abnormal enlargement of the scrotum on one side. Detailed preoperative physical examination and imaging examination are necessary and need to be combined with histopathology，immunohistochemistry and genetic testing to confirm the diagnosis. Surgical resection is the preferred treatment，which can be supplemented with chemoradiotherapy and molecular targeted therapy if necessary. Close follow-up should be conducted after radical resection.