Multicystic malignant mesothelioma of the tunica vaginalis with an unusually indolent clinical course

Abstract

48歳男性.1ヵ月来の右陰嚢の無痛性腫脹を主訴に受診となった.超音波検査およびCTでは右陰嚢内に多嚢胞性腫瘍を認めるも, 遠隔臓器およびリンパ節転移は認めなかった.また, 精巣腫瘍マーカーはいずれも正常範囲内であった.悪性腫瘍を疑い高位精巣摘除術を施行したところ, 多嚢胞性腫瘍はfibrocellular, microcystic, adenomatoidな成分で構成され, 精巣鞘膜原発のbiphasic malignant mesotheliomaと病理学的に診断された.なお, 精巣や精巣上体, 陰嚢への浸潤は認めなかった.術後72ヵ月経過した現在も, 再発転移は認めていない

We report an extremely rare case of a multicystic malignant mesothelioma in the tunica vaginalis with an unusually indolent clinical course. A 48-year-old man presented with a one-month history of painless swelling of right scrotal contents. Ultrasonography and computed tomography (CT) revealed a multicystic mass in the right scrotal sac with evidence of neither distant nor lymph node metastases. The testicular tumor markers were within the normal limits. Inguinal orchiectomy was performed under the suspicion of a malignant tumor. The cystic tumor consisted of fibrocellular, microcystic and adenomatoid elements microscopically was diagnosed biphasic malignant mesothelioma of tunica vaginalis but no invasion into the testis, epididymis and also scrotum. The patient has been disease-free for 72 months and is being followed on an outpatient basis with no further adjuvant therapy.