胃癌原発転移性精索腫瘍の1例

Metastatic Tumor of the Spermatic Cord from Gastric Cancer:A Case Report

　57歳，男性。主訴は右陰嚢内無痛性腫瘤。精索腫瘍を疑い，高位精巣摘除術を施行した。腫瘍は右精索部に存在し，腹膜まで硬結が続き，腹水も認められた。組織学的診断は転移性腺癌であった。腹水細胞診はclass Vであり，癌性腹膜炎と診断された。術後の精査により胃癌が発見され，原発巣と考えられた。自験例を含めて，本邦では転移性精索腫瘍は69例が報告されている。自験例は転移経路として腹膜播種による直接浸潤が示唆された珍しい症例である。

A 57-year-old patient with the complaint of a painless tumor in the right scrotum was suspected to have a tumor of the spermatic cord and underwent high orchiectomy. The tumor was hard and located in the right spermatic cord, which was continuous to the peritoneum and ascites was also found. Histological examination was metastatic adeno-carcinoma and cytology of ascites was class V. Postopera-tive examinations revealed gastric cancer and it was con-sidered to be the primary tumor. He died of peritonitis carcinomatosa one month after the surgery.