両側精索に原発したと思われる左睾丸および両側精索の悪性androblastomaの1例

Abstract

1. A case of malignant androblastoma manifested primarily in the spermatic cords bilaterally and presumably secondarily in the left testis is presented. The patient, a 50-year-old man, was admitted to our hospital on June 23, 1975, complaining of painless firm masses in the scrotum on both sides of several months duration. There was no gynecomastia. Right inguinal orchidectomy was pereformed on July 3, left inguinal orchidectomy on July 23, and the exstirpation of the metastatic nodule from the skin of the left thigh on August 21, with postoperative chemotherapy with 5FU (250 mg X 23). This patient died on September 15, due to enlarged metastases about 2 months after the first operation. 2. Authors could collect 70 cases of androblastoma from the literature up to the end of 1975 including authors’ case, and a statistical survey was made on 70 cases of androblastomas with a discussion on its clinical features, pathohistology, histogenesis, nomenclature and differential pathohistology. 3. In the age distribution androblastoma showed two peaks, the highest one at the age of 0～1 year and the other at 30～34 years. The youngest is 5 hours old and the oldest 90 years old. 4. Gynecomastia has occurred in 15 of 70 (21.4%) as a whole, in 11 of 60 (18.3%) benign and in 4 of 10 (40%) malignant tumors. 5. Authors summarized 10 cases of malignant androblastoma up to date including authors' case and a discussion was made on its clinical features, pathohistology, therapy, prognosis, metastasis and predisposing factors. 6. In the literature up to date, authors could not find a report of primary androblastoma in the spermatic cord, namely in an extratesticular site. Most probably, the tumor of authors' case originated from aberrant cell elements of the primitive gonadal blastema located in the spermatic cord.