膵癌の精索転移

A REPORT OF A CASE OF METASTATIC TUMOR OF THE SPERMATIC CORD FROM PANCREAS TAIL CANCER

　62歳男性。排尿痛，頻尿，右鼠径部痛，上腹部痛，両鼠径部腫瘤などを主訴として当科受診。初診時上腹部にも腫瘤を触知し，腹部エコーにて膵尾部に腫瘍が認められた。前立腺は軽度の肥大を示すのみであり酸性ホスファターゼも正常であった。鼠径部腫瘤は両側とも精索より発しており，腫瘤摘除を含めた高位除睾術を施行した。病理組織学的には精索腫瘤は中分化型の腺癌であり，膵尾部癌の両側精索転移と診断した。

A 62 year-old male was admitted with the complaints of urination pain, urinary frequency, right inguinal pain, upper abdominal pain and bilateral inguinal masses. Physical examination revealed firm non-tender unmovable masses about 2 cm in diameter in the bilateral groin, and an upper abdominal mass about 10 cm in diameter. Digital examination, urethrography and transrectal ultrasonography showed mild hyperplasia of the prostate, and blood level of prostatic acid phosphatase was normal. Abdominal ultrasonography, CTscan and ERCP showed pancreas tail cancer.