炎症を契機に診断されたセミノーマ

Seminoma with an acute inflammatory reaction：A case report

49歳，男性。発熱，左陰囊腫大を主訴に受診。診察上，左精巣上体炎が疑われ，抗菌化学療法目的に入院した。入院後，抗生剤投与するも，炎症反応が遷延するため画像検査を行ったところ，左精巣腫瘍が疑われ，高位精巣摘出術を施行した。病理組織学的に，精巣上体には炎症所見は認められず，広範な壊死を伴ったセミノーマと診断された。術後，炎症反応はすみやかに消退し，腫瘍と発熱との関連性が示唆された。

A 49-year-old man presented with chief complaints of high grade fever and left scrotal swelling. Physical examination led to a tentative diagnosis of left epididymitis,so he was admitted for antibiotics therapy. Because,the inflammatory reaction prolonged in spite of meticulous chemotherapy additional examinations were undertaken. Ultra sonography and magnetic resonance imaging resulted in a suspicion of a left testicular tumor,therefore,a high inguinal orchiectomy was carried out. Pathological examination revealed seminoma with massive necrosis. After the operation,the inflammatory reaction disappeared immediately.