精巣鞘膜に発生したhCG産生悪性中皮腫

Malignant mesothelioma of testicular tunica vaginalis : A case report

68歳男性．右有痛性陰囊腫大を主訴に当科受診．右精巣腫瘍の臨床診断で高位精巣摘除術を施行．病理結果は悪性中皮腫であった．術後補助療法は患者の意向により施行できず，術後3か月で急速な腹膜播種を来し癌死した．精巣鞘膜から発生した悪性中皮腫は本邦35例目の報告で，非常にまれな疾患である．腫瘍の特性から補助療法は積極的に行うべきであると考えられた．

Abstract

Malignant mesothelioma of testicular tunica vaginalis is rare, and usually not diagnosed until surgery is undertaken. We report here a case with malignant mesothelioma of testicular tunica vaginalis. A 68-year-old man presented with pain and swelling of the right scrotum. The tumor was resected under the diagnosis of testicular malignant tumor. However, histopathological assessment revealed malignant mesothelioma of testicular tunica vaginalis. Three months after operation, he died due to acute local recurrence and peritoneal metastasis. To our knowledge, 34 cases of malignant mesothelioma of testicular tunica vaginalis have been reported in Japan and this case is thought to be the 35th case in Japan (Rinsho Hinyokika 75 : 73-76, 2021).