陰囊壁原発の平滑筋肉腫

Leiomyosarcoma of the scrotum

患者は61歳，男性。主訴は左陰囊内の腫瘤。左陰囊内に鶏卵大で表面平滑の腫瘤を触知した。圧痛はなく，左精巣・精巣上体との判別は困難であった。検査データに異常はなく，超音波所見は充実性で内部均一であった。左精巣または精索腫瘍を疑い，左高位精巣摘除術を施行した。組織学的に陰囊壁原発の平滑筋肉腫と診断した。術後5か月の現在，再発の徴候はない。陰囊壁原発の平滑筋肉腫は稀で，今回の症例は本邦で15例目と考えられた。

A 61-year-old man presented with left scrotal swelling. Physical examination revealed a nontender and smooth tumor in the left scrotum,which was of hens' egg size. The tumor could not be distinguished from the left testis and epididymis. Laboratory studies were within normal limits. Ultrasonogram showed a solid and regular mass. Left testicular or spermatic cord tumor were suspected and left high orchiectomy was performed. Pathological examination revealed a leiomyosarcoma arising from the scrotal wall. The patient has been followed up for 5 months with no evidence of recurrence. Leiomyosarcoma of the scrotum is considered to be rare and only 15 cases have been reported in the Japanese literature.