Metastatic tumor of the spermatic cord from renal cell carcinoma

Abstract

患者は56歳, 男性で肉眼的血尿を主訴とし来院した, 諸検査にて下大静脈腫瘍血栓を伴う右腎細胞癌の診断を得, 根治的右腎別除術および腫瘍血栓別出術が施行された.剔除腫瘍は組織学的にrenal cell carcinoma(clearcellsubtype)であった。再発を認めず術後1ヵ月目に退院した。退院後6ヵ月目に陰嚢内の腫瘤にきづき来院し転移性精索腫瘍の診断の下に右精巣摘除術が施行された.腫瘍は右精索に位置し組織学的にはrenal cell carclnoma(clear cell subtype)で腎細胞癌の転移と思われた.自験例は, 腎細胞癌が精索静脈を経て精索に転移をきたしたものと思われた.腎細胞癌では経過観察期間中, 精索も含めた全身的観察が必要である.

A 56-year-old male visited our hospital with macroscopic hematuria. Physical and X-ray examinations showed he had right renal cell carcinoma with tumor thrombosis in the inferior vena cava and the right spermatic vein. Radical nephrectomy and tumor thrombectomy were performed and he was discharged with no evidence of disease 1 month after the operation. At 5 months after the discharge, he noticed a palpable mass in the scrotum. Right orchiectomy was performed. The tumor was located in the right spermatic cord and histological examination revealed it to be a renal cell carcinoma (clear cell subtype) which was a metastatic lesion from a right renal tumor. In this case, the renal cell carcinoma was considered to have retrogradely metastasized through the spermatic vein. In conclusion, a complete physical examination, including the spermatic cord is recommended during the follow-up period of renal cell carcinoma.