精索平滑筋肉腫の1例

Abstract

44歳男.左無痛性鼠径部腫瘤を自覚し, 陰嚢内悪性腫瘍の診断で, 高位精巣摘除術を施行された.病理組織学的検査結果は精索発生の平滑筋肉腫であった.補助療法は行わず経過観察したが, 肺転移, 副腎転移し, 血痰が出現した.貧血を認め, 成熟好中球を主体とした高度の白血球増多が認められた.また, CRP上昇以外は血清生化学検査は正常範囲で, 血清G-CSF活性は上昇していた.胸部単純X線肺転移像が, 腹部CTで両側副腎転移像が認められた.軟部肉腫に対し, CYVA-DIC療法を施行したが効果なく死亡した.なお, 病理組織所見は原発巣の組織所見と一致していた

A 44-year-old male was referred to our hospital for further treatment of lung and adrenal metastases from leiomyosarcoma occurring in the left spermatic cord. He had undergone high orchiectomy 5 months before, but no adjuvant therapy was done. Although systemic CYVADIC therapy (cyclophosphamide, vincristine, doxorubicin hydrochloride, dacarbazine) was performed in our hospital, he died of metastatic disease 10 months after the initial therapy. Leiomyosarcoma arising in the spermatic cord is a rare entity. We present a case of leiomyosarcoma of the spermatic cord, and to our knowledge, this is the 23rd case reported in Japan.