水腫穿刺により異型細胞を認めた陰囊内悪性中皮腫

Malignant mesothelioma of tunica vaginalis testis with atypical cells in aspirated fluid of hydrocele

81歳，男性。右陰囊の腫脹・疼痛を訴え近医受診。精巣腫瘍を疑われ当科に紹介された。陰囊は小児頭大に腫大し弾性硬で，超音波検査およびCTで内部不均一な囊胞状の腫瘤が認められた。右精巣・精巣上体は確認されなかった。右陰囊内悪性腫瘍を否定できないため，右高位精巣摘出術を施行した。病理組織検査より悪性中皮腫と診断された。術後11か月に右胸膜への転移が明らかとなり19か月に癌死した。

A 81-year-old man presented with right scrotal swelling and pain. Ultrasonography and CT-scan revealed an irregular cystic mass in the scrotum. Right testis and epididymis could not be identified. Since an intrascrotal malignant tumor was strongly suspected,the patient underwent right high orchiectomy. Histological and immunohistochemical examination demonstrated that this tumor was malignant mesothelioma of tunica vaginalis. Although no distant metastasis was found on the first examination,the patient died 19months later from right pleural metastasis.