鼠径部腫瘤を契機に発見された精索線維肉腫の1例

Abstract

We report a case of fibrosarcoma of the spermatic cord detected with an inguinal tumor. A 45-yearold man was admitted to our hospital for further examination of a right inguinal tumor. Computed tomography (CT) and magnetic resonance imaging revealed a right spermatic cord tumor, 45 mm in size, and a retroperitoneal tumor in proximity to the right external iliac artery, 55 mm in size. He was clinically suspected as having malignant lymphoma. As the differential diagnosis, liposarcoma and leiomyosarcoma were considered. High orchidectomy was performed for the purpose of diagnosis. The histopathological examination suggested fibrosarcoma, with a positive surgical margin. Six days after high orchidectomy, retroperitoneal tumor extirpation was performed. Total resection was difficult because the adhesion with the external iliac vein was strong. The tumor was extirpated as much as possible. The result of the histopathological examination showed fibrosarcoma. Adjuvant radiotherapy (54 Gy) was performed. After radiotherapy, local recurrence was detected by CT. He underwent systemic chemotherapy with adriamycin (60 mg/m2). After 3 courses, there was a slight reduction in tumor size. However, his general condition rapidly deteriorated with marked cachexy and he died six months from the first medical examination.