陰嚢内平滑筋肉腫の1例

Abstract

27歳男.10年以上前から左陰嚢の腫大を自覚していたが放置していたところ, 今回, 左下腹部から陰嚢にかけての痛みが出現したため来診した.初診時, 左陰嚢内に精巣とは別に7cm大, 弾性硬, 可動性良好の腫瘤を触知した為, 精査加療目的で入院となった.画像所見から確定診断がつかず, 悪性疾患の可能性も否定できない為, 陰嚢内腫瘍摘出術を施行した.摘出腫瘍は7×6×3.5cmの不整な形をした白色結節が多数癒合しており血管に富んでいた.摘出標本の免疫組織学的検査でα-smooth muscle actin抗体による染色が陽性であったことから高分化型平滑筋肉腫と診断された.自験例を含め報告された29例について文献的考察を加え報告した

Leiomyosarcoma of the scrotum is a rare tumor. Up to 1999, only 29 cases have been reported in the literature worldwide. A 27-year-old man presented with a mass on the left side of the scrotum which had been painless and had gradually enlarged over the previous 10 years. During the following 3 months, however, it became painful and he was then referred to our hospital. Physical examination revealed a solid mass on the left side of the scrotum, measuring 7 cm in diameter, which was not adhering to the testis or to the vas deferens. The tumor was surgically resected. The histological examination confirmed the diagnosis of well differentiated leiomyosarcoma. Adjuvant therapy was considered unnecessary. The follow-up at 41 months revealed no local recurrence or distant metastasis.