原発性精巣カルチノイドの1例

Abstract

66歳男性.患者は交通事故で右大腿骨骨幹部骨折, 膝窩動脈損傷で緊急入院した.大腿骨創外固定術, 膝窩動脈再建術後, 右陰嚢内容の腫脹で著者らの施設へ依頼があり, 右精巣腫瘍と診断し右高位精巣摘除術を施行した.摘出標本は大きさ9×6×5cmの暗黄色充実性で, 均一に硬い腫瘍が白膜内ほぼ全域を占めていた.組織所見では腫瘍は充実性, 胞巣状構造の腫瘍細胞で構成され, 間質は毛細血管を含む硝子化した膠原線維からなり, 辺縁で浸潤性増殖を認めた.腫瘍細胞は均一で円形, 小型, 核は円形, 細胞質は弱好酸性, 核分裂像は認めず, 免疫化学染色ではchromogranin, NSE, synaptophysin, serotoninは陽性であった.術後の精査では他の原発巣, 転移を認めず, 最終的に原発性精巣カルチノイドと診断された

A 66-year-old male was hospitalized with right femur fracture and injury of the popliteal artery sustained in a traffic accident. The patient underwent external fixation and repair of popliteal artery. At operation, the orthopedists noticed a mass in the scrotum and requested our consultation. A right orchiectomy was done under the diagnosis of a testicular tumor. The tumor measured 9 x 6 x 5 cm in size. Histological diagnosis was pure carcinoid of the testis. Computerized tomography and other studies showed no tumorous lesions elsewhere. Symptoms of a carcinoid syndrome were not noted. No evidence of metastasis has been seen for 12 months after surgery.