転移性精索腫瘍の1例

A CASE OF METASTATIC SPERMATIC CORD TUMOR FROM PANCREAS CANCER

　81歳，男性．陰嚢内腫瘤を主訴に来院した．睾丸腫瘍を疑い右高位除睾術を行ったところ，病理組織学的に精索の転移性腺癌と考えられた．原発巣の検索を行ったが，腫瘍マーカーの上昇もなく，画像診断上も異常は認められなかった．1年後，食欲不振，腹部膨満を訴え再入院．CEA,CA19-9,DUPAN−2の上昇がみられ，CTにより膵尾部の腫大が認められた．更に組織化学的検討も加え，本症例を膵癌精索転移と診断した．

A 81 year old man was referred to our hospital because of an intrascrotal tumor. Right testicular tumor was suspected, and radical orchiectomy was done. Pathological diagnosis was metastatic adenocarcinoma of the spermatic cord. Various serum markers and radiographic examinations faild to disclose the original organ of the tumor. One year later, he was rehospitalized because of appetite loss and abdominal distension. Raised CEA, CA19-9, and DUPAN-2, and a swelling of the pancreatic tail revealed by CT scan suggested pancreatic carcinoma. Histochemical analyses showed that the origin was the pancreas.