精巣原発と思われた腺癌

ADENOCARCINOMA OF THE LEFT TESTIS : A CASE REPORT

　64歳，男性。左陰嚢腫大を主訴に来院。左精巣腫瘍を疑い，1990年5月17日に左高位精巣摘除術を施行した。病理組織学的所見は乳頭状腺癌であった。転移性腫瘍を疑い原発巣の検索を行ったが，血中癌胎児性抗原（CEA）が異常値を示すのみで，原発巣は確定できず，精巣原発であると思われた。術後6年を経過しているが，再発もなく経過は順調である。筆者らの調べ得た限りでは，本症例は本邦4例目にあたる。

A 64-year-old man with chief complaint of the swelling of the left scrotum without pain underwent left orchiectomy in May 17 1990 under the diagnosis of testicular tumor. The pathological diagnosis was papillary adenocar-cinoma of the testis. We suspected metastatic tumor, but no other malignancy was found elsewhere in his body. The serum CEA (carcinoembryonal antigen) was slightly elevated. We recognized that the cancer was primary. Although six years have passed since orchiectomy, the patient has been in good health. Our case is thought to be the forth case of adenocarcinoma of the testis in Japan.