左陰嚢内及び鼠径部に発生した精索脂肪肉腫の1例

Abstract

画像診断, 腹部造影CT共に左鼠径部と陰嚢内に内部不均一な腫瘤が認められた.左精巣腫瘍, 特に高年齢から悪性リンパ腫が疑われたが, 3年前に肺結核を患っていることより結核性の精巣上体炎や精巣結核も除外必要にて, 左高位精巣摘除術を施行した.病理組織学的所見は, 精細管等の固有構造は保たれているものの軟部組織に大小の成熟脂肪細胞と膠原線維を含む線維化が認められ, 分化型脂肪肉腫の硬化型(sclerosing type)と診断された.分化型の脂肪肉腫にて術後補助療法は施行せず, 術後12日目に退院となった.術後8ヵ月現在局所再発などは認めていない

We report a rare case of liposarcoma of the spermatic cord in the left scrotum and inguinal region. The patient was a 75 year old male, who visited our hospital with the complaint of painless left scrotal swelling and inguinal mass which had been noticed for 3 to 4 years. Ultrasonography and computed tomography (CT) showed a heterogenous mass in the left inguinal region and intrascrotum. We suspected a left testicular tumor and removed it by high inguinal orchiectomy. Histological examination revealed a well-differentiated liposarcoma of sclerosing type. Tumor local recurrence was not recognized at 8 months after operation. This is the 43rd case of liposarcoma of the spermatic cord in the Japanese literature.