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Title: 会陰部-陰嚢内に発生した悪性中皮腫の1例
Other Titles: A case of malignant mesothelioma presenting as a perineal and intrascrotal mass
Authors: 鷲野, 聡 researcher_resolver_name
寺内, 文人 researcher_resolver_name
松崎, 敦 researcher_resolver_name
小林, 裕 researcher_resolver_name
Author's alias: Washino, Satoshi
Terauchi, Fumihito
Matsuzaki, Atsushi
Kobayashi, Yutaka
Keywords: Malignant mesothelioma
Intrascrotal tumor
Issue Date: Sep-2008
Publisher: 泌尿器科紀要刊行会
Journal title: 泌尿器科紀要
Volume: 54
Issue: 9
Start page: 619
End page: 623
Abstract: 42歳男。患者は会陰部~陰嚢内にかけての腫瘤を主訴とした。骨盤部CT検査では会陰部膿瘍が疑われ, 腫瘤の穿刺ドレナージを施行したが, 内溶液は血性であった。その後, 穿刺部から200~300ml/日の出血が続き, 内陰部動脈末梢に血管の増生を認めたため, 腫瘤は腫瘍性病変の可能性が高いと判断し, 内陰部動脈塞栓術の後, 会陰部・陰嚢内腫瘍摘出術が施行された。病理組織学的所見で上皮型の悪性中皮腫と診断され, 術中所見では腫瘍は不完全切除の可能性が高いと思われたものの, 病理学的所見では切除断端陰性であり, 術後は補助療法なしで経過観察とした。しかし, 術後2ヵ月経過で局所再発を来し, 再発部位からは高度の出血がみられ, 頻回の輸血を必要とした。再手術を施行したが, その後も再発を繰返し, 初診から6ヵ月後に患者は死亡となった。尚, 本症例では腫瘍は会陰部・陰嚢内の正中に位置し, 両側の精巣, 精巣上体, 精索への明らかな浸潤は認めず, 従来の報告にある発生部位とは異なっていた。このような部位に発生した悪性中皮腫の我が国での報告は2例のみであった。
We report here a case of malignant mesothelioma presenting as a perineal and intrascrotal mass. A 42-year-old Japanese male presented with an enlarging mass in the perineum and intrascrotum. Although the initial clinical diagnosis was perineal abscess, angiography revealed a tumor in the perineum and intrascrotum. The tumor was resected, and the pathological examination revealed malignant mesothelioma. Two months after the operation, a hard irregular mass with severe hemorrhage was noticed in the perineum, and was resected. A few weeks after the second operation local recurrence and, inguinal and intrapelvic retroperitoneal lymphadenopathy were found. Radiotherapy to recurrent sites was not effective. The patient died six months after the initiation of therapy. To our knowledge, 24 cases of malignant mesothelioma in the perineum or intrascrotum were reported in Japan and this case was thought to be the 25th case in Japan.
Rights: 許諾条件により本文は2009-10-01に公開
URI: http://hdl.handle.net/2433/71734
PubMed ID: 18975578
Appears in Collections:Vol.54 No.9

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