直腸癌に併発した精索脂肪肉腫の1例

Abstract

78歳男性。患者ははじめ左鼠径部の腫脹を自覚し, 更に便秘および下血が生じ, 著者らの施設にある消化器外科へ受診, 直腸癌と診断された。今回, 左鼠径部腫脹の精査加療目的で著者らの泌尿器科へ紹介となり, 超音波・CT・MRIの結果, 左精索腫瘍と診断された。直腸癌に対するHartmann手術と同時に左高位精巣摘除術を施行したところ, 病理組織学的には直腸低分化型腺癌に併発した精索脂肪肉腫であった。術後6ヵ月経過した時点では精索脂肪肉腫の再発, 転移は認められなかったが, 患者は最終的に直腸癌の増悪のために死亡となった。

We report a case of liposarcoma of the spermatic cord associated with rectum cancer. A 78-year-old man visited our hospital with a complaint of painless left inguinal mass. He also showed constipation and bloody bowel discharge, rectum cancer was diagnosed by further evaluation. Ultrasonography, computed tomography and magnetic resonance imaging revealed a 2 x 4 x 6 cm mass in the left spermatic cord. Left high orchiectomy for the left inguinal tumor and Hartmann's procedure for rectum cancer was performed. Histologically, the mass in the left spermatic cord was well differentiated liposarcoma and rectum cancer was poorly differentiated adenocarcinoma. He died from rectum cancer with no evidence of recurrence of liposarcoma of the left spermatic cord after follow up for 6 months.