ダウン症候群に合併した精巣腫瘍

A case of testicular tumor associated with Down's syndrome

　症例は31歳，男性。生下時よりダウン症候群の診断を受けていた。右陰囊腫大を認め，近医より右精巣腫瘍を疑われ当科に紹介となった。右高位精巣摘除術を施行し，病理結果はセミノーマの診断であった。転移などは認めなかったので外来で経過観察していたが，術後2年3か月で再発を認めた。BEP療法を2コース行ったが，敗血症性ショックを発症し，永眠した。

A 31-year-old man with Down's syndrome consulted our hospital with the chief complaint of a painless right intrascrotal mass. Right high inguinal orchidectomy was performed and the pathological findings showed a seminoma. The patient received no further treatment because the cancer seemed to be localized. But 27 months after operation, abdominal CT scan showed retroperitoneal lymph node metastasis with elevated β-HCG level. The patient was treated with cisplatine, etoposide and bleomycin（BEP therapy）, however, he died of serious bacterial infection after two courses of the chemotherapy.