超音波検査にて術前診断が困難であった精巣類表皮嚢胞の1例

Abstract

64歳男.超音波検査上, 正常精巣と同様なエコーパターンを示し, 術中迅速病理組織診で診断しえた精巣類表皮嚢胞の症例について報告した.左陰嚢部無痛性腫脹を主訴とし, 超音波断層検査では精巣実質の左側腫大を認めた.エコーパターンは右正常精巣と同様であり, 左精巣には腫瘤壁を示唆する所見は認めなかった.中迅速病理組織診で類表皮嚢胞の診断であり, 腫瘍が精巣全体を占拠していたため左精巣摘出術を選択した.境界明瞭な単房性嚢胞病変が見られ, 嚢胞壁の一部は重扁平上皮からなり, 嚢胞内部には角化物の貯留が認められた.そのため左精巣類表皮嚢胞と診断された

A case of epidermoid cyst of the testis is presented. The patient was a 64-year-old man who complained of a painless mass in the left scrotum. Physical examination revealed a hen-egg sized enlargement of the left scrotal contents. The ultrasonographic appearance did not show a hyperechoic partition, which is called echogenic rim, a characteristic of this tumor on the echoic examination, and was homogeneous, almost similar to that of a normal testis. Because malignant testicular tumors could not be excluded preoperatively, excisional biopsy of the left testis was performed first. Histological diagnosis was an epidermoid cyst of the testis. As the left testis was almost completely occupied by the tumor and no normal testicular tissue was recognized, we performed orchiectomy additionally. Epidermoid cyst of the testis is a rare benign tumor that accounts for about 1 percent of all testicular tumors. It clinically resembles malignant testicular tumors, and orchiectomy is often performed for treatment. About 154 cases of testicular epidermoid cyst have been reported in the Japanese literature and are reviewed briefly here.