性腺外胚細胞腫瘍との鑑別が問題となったBurned-out tumorとCarcinoma-in-situを認めた精巣腫瘍の1例

Abstract

性腺外胚細胞腫瘍と考えられた症例の精巣の超音波所見で, 高エコー領域として描出されるburned-out tumorを認めた.又, 摘出精巣の周囲精細管上皮に異型性を認め, 諸家の報告する精巣CIS病変であると診断された

Multiple tumors of mediastinum, retroperitoneum and lung were detected in a 40-year-old man presented with lumbago and lower abdominal pain. As biopsy specimen taken from the cervical lymph node suggested germ-cell tumor and his testes were normally palpable, the initial diagnosis was an extragonadal germ-cell tumor. However, since ultrasonography of his left testis showed a small high echoic lesion (5 mm) assumed to be a burned-out tumor, orchiectomy was performed. Histological findings confirmed scar tissue as burned-out tumor and also revealed some malignant cells lining the seminiferous tubules that were thought to be the carcinoma-in-situ of the testis. After chemotherapy of etoposide and cisplatinum he achieved a partial response which has been maintained for 7 months. Examinations for burned-out tumor or carcinoma-in-situ of the testis should be made for the patients with an extragonadal germ cell tumor who have normally palpable testes.