睾丸腫瘍の臨床的観察

Abstract

愛知医科大学附属病院にて経験した睾丸腫瘍について臨床的観察をおこなった.1) 1974～1983年までの10年間に19例を経験した.この期間中の男子外来患者数は6, 097名, 男子入院患者数は1, 097名で, 睾丸腫瘍の割合は, それぞれ0.31%と1.73%であった.2)年齢は, 10歳以下の小児期と20～40歳代にピークがみられ, 平均年齢は27.8歳であった.3)患側は左11例, 右側8例であった.4)主訴としては, 睾丸の無痛性腫脹が17例(89.4%)を占めた.5)停留睾丸および外傷の既往を持ったものはなかった.6)組織学的分類では, 1型9例, 2型4例, 3型1例, 4型4例, malignant lymphoma 1例であった.7)実測生存率は3年および5年ともに81.8%であった.8)治療は全例に高位除睾術を施行, ただし後腹膜リンパ節郭清術はおこなっていない.術後の補助療法としては放射線療法, 化学療法の単独あるいは併用をおこなった

The 19 cases of testicular tumors treated at our Hospital between 1974 and 1983, were reviewed retrospectively. The incidence of testicular tumors among the male outpatients in our urologic clinic was 0.31%. The patients ranged in age from 1 to 76 years old (average: 27.8 years old). The affected side was the left side in 11 and the right side in 8 cases. The most frequent symptom was a painless mass of the testis. Histopathological diagnosis according to the classification by Dixon and Moore was type I in 9 cases, type II in 4 cases, type II in 1 case, type IV in 4 cases. Thus germinal tumors accounted for 18 (94.7%) of the cases. One case (5.3%) of malignant lymphoma was non-germinal. As for the age distribution, two peaks were noted in testicular tumors, especially in cases with potential embryonal carcinoma, between 1 and 2 years and between 19 and 32 years. On the other hand, the cases with potential seminoma showed one peak between 25 and 44 years. The treatment consisted of high orchiectomy alone, orchiectomy with radiation, orchiectomy with chemotherapy or orchiectomy with radiation and chemotherapy. Retroperitoneal lymphadenectomy was not done in any case. The over-all 3-year and 5-year actual survival rates were both 92%.