大腸癌術後の精索転移

Metastatic spermatic cord tumor from sigmoid colon cancer : A case report

　81歳男性．3年前にS状結腸癌とその肝転移に対し，S状結腸切除術・肝部分切除術を施行し，術後経過観察中であった．3か月前からの左無痛性陰囊腫大にて当科受診，左精索に硬い腫瘤を触知した．CEA，CA19-9は軽度上昇していた．精索腫瘍を疑い，左高位精巣摘除術を施行した．病理組織学的所見は中分化管状腺癌で，S状結腸癌の転移と診断した．術後2か月で新たに肝転移が指摘され，術後4か月で他因死した．

Abstract

A 81 year-old man, who had undergone colon resection and partial hepatectomy for sigmoid cancer and its liver metastasis 3 year earlier came to our hospital with a complaint of a swelling mass in the left scrotum. Physical examination showed left scrotal hydrocele and hard nodule in the left spermatic cord. The CEA and CA19-9 value were found a bit elevated. We performed high orchitectomy. The mass in the spermatic cord was 40 × 25 × 25 mm in size, and histopathological diagnosis was moderately differentiated adenocarcinoma, metastasis from sigmoid colon cancer. The patient died 4 months later. Metastatic tumor of the spermatic cord is rare but critical. We should cite metastatic tumor as a diagnosis of tumor of the spermatic cord or tumor in the scrotum particularly when the patient has had an operation of the digestive system (Rinsho Hinyokika 78 : 77-80, 2024).