食道癌を原発とする転移性陰茎腫瘍の1例

Abstract

We report a 68-year-old man with a metastatic tumor of the penis originating from an esophageal carcinoma that had been removed two years ago. Multiple metastases were present on the liver, brain, eye and penis for the past year. He consulted with our department complaining of severe penile pain and dysuria. Solid masses were palpated in the penile sponge and the ventral glans was necrotic. Histological examinations indicated a metastatic squamous cell carcinoma. A total penectomy was performed for the purpose of managing local symptoms. Following operation, the penile pain improved; however, he died three months after the operation.

68歳男。約2年前の食道癌による胸腹部食道亜全摘除術施行後に脳転移と更に肝、左眼底および陰茎転移が出現した。全身化学療法の効果は乏しく、対症療法を行っていたが陰茎転移による疼痛、排尿困難が増強して当科を受診した。陰茎海綿体のほぼ全体に硬結を触知し、亀頭腹側は一部壊死し、陰茎持続勃起症を認めた。壊死病変の疼痛が強く、尿道カテーテル留置が困難なため、陰茎全摘除術を施行し、病理所見から陰茎海綿体に扁平上皮癌を認めて食道癌の転移と診断した。局所の疼痛はコントロールでき、排尿も尿道カテーテル留置で管理できたが、術後3ヵ月目に癌性悪液質のため死亡した。