睾丸間質細胞腫瘍の1例

Abstract

A case of bilateral interstitial cell tumor of the testis was reported. The patient was 23 years old who complained bilateral swelling of scrotal contents. On laboratory examination after admission, urinary 17-KS was 63.1mg/day, and the tumors were supposed of having high endocrine activity. On physical examination, the patient was hursuite, but with no sexual abnormality and gynecomastia. Bilateral orchiectomy was performed, and the histological diagnosis was interstitial cell tumor on both sides with the tubular destruction of the seminiferous tubuli due to massive increase of tumor cells. After orchiectomy, urinary 17-KS was still in high level, and the enlarged para-aortic lymphnodes were found on lymphangiogram. Because metastasis was strongly suspected the transperitoneal retroperitoneal lymphadenectomy was done. But the resected lymphnodes revealed no metastasis. The retroperitoneal pneumography and adrenal scintigram carried out postoperatively suggested bilateral adrenal hypertrophy, but after then the urinary 17-KS gradually reduced. Postoperatively sustained level of the urinary 17-KS was thought to be caused by the transient reaction of the adrenals. Interstitial cell tumor were reported over 100 cases in foreign literature• and eleven cases in Japan up to date. We discussed about its malignancy, endocrine activity and treatment of this disease.