交叉性精嚢転位

CROSSED ECTOPY OF A SEMINAL VESICLE

　42歳，男性．下腹部痛で来科．静脈性尿路造影で左腎は造影されず，膀胱内に尿管瘤様の陰影欠損を認めた．精嚢造影では左精管および精嚢が交叉性に右側に転位しており，精嚢から径6mmの瘻管を通して拡張した尿管が描出された．左腎尿管摘除術を施行．瘤状に拡張した尿管は膀胱後壁を構成しており，同部の膀胱筋層は欠損していた．痕跡腎は精巣上体類似の組織構造を有していた．

We report a rare case of crossed ectopy of a seminal vesicle. A 42-year-old man presented with a 2-year history of right lower abdomonal pain. Excretory urography showed no dye excretion from the left kidney and a 8 x 6 cm filling defect in the bladder. Vasovesiculography revealed the left seminal vesicle translocated to the right side with the ipsilateral vas deferens crossing over the midline. The left ureter, visualized via the seminal vesiculography, showed a cystic dilatation in the lower part. Surgical exploration showed lack of musculature in the bladder wall abutting on the dilated ureter. Nephroureterectomy was performed.