精索転移をきたした膵癌

A CASE OF PANCREATIC CANCER METASTATIC TO THE SPERMATIC CORD

　77歳，男性．右鼠径部に索状の腫瘤を認めた．エコー上，精索水腫とその被膜の肥厚を認め，穿刺液の細胞診はclassV（腺癌疑い）であった．右精索を内鼠径輪部より摘出したところ，固有鞘膜全体に腺管癌の浸潤を認め，膵癌の精索転移が強く疑われた．患者は癌性腹膜炎により死亡した．剖検にて膵体尾部癌が確認された．転移経路としては腹膜からの直接播種が考えられた．

A 77-year-old man noticed a mass in the right inguinal region. Ultrasonography showed a hydrocele funiculi with thick capsule. The puncture-exudate revealed class V in cytology. The right spermatic cord tumor was resected with high ligation technique. The histopathological findings demonstrated duct cell adenocarcinoma diffusely invading the tunica vaginalis testis and metastasis from pancreatic cancer was most suspected. The patient died with peritonitis carcinomatosa about a month postoperatively. Autopsy confirmed metastatic tumor of the spermatic cord from cancer of the pancreas body and tail.