根治的切除が行われた精索平滑筋肉腫

Leiomyosarcoma of the spermatic cord : A case report

　75歳男性．4か月前から左無痛性陰囊腫大を自覚，増大傾向のため当科受診．左精索腫瘍の診断で左高位精巣摘除術施行．病理で精索平滑筋肉腫と診断．切除断端は陰性で転移所見を認めないこと，組織学的悪性度（FNCLCCグレード1）および臨床病期（AJCC stage IA）から良好な予後が見込まれ，補助療法は行わなかった．われわれは精索平滑筋肉腫の1例を経験したので文献的考察を加えて報告する．

Abstract

A 75-year-old man presented to our hospital, complaining of enlarging painless hard mass in the left scrotum for 4 months. Left orchiectomy with high ligation of the spermatic cord was performed under the clinical diagnosis of the spermatic cord tumor. Histopathologically, the tumor was diagnosed as leiomyosarcoma sized 2.3 cm, primarily, arising from the spermatic cord. Surgical margin was negative and distant metastases were not observed at image inspections. Because of the low grade tumor in FNCLCC grading system, we did not perfomed adjuvant therapy. There has been neither local recurrence nor metastasis for 24 months after the operation. Leiomyosarcoma of the spermatic cord is rare. This is the 45th case of primary leiomyosarcoma of the spermatic cord in Japan (Rinsho Hinyokika 72 : 927-931, 2018).