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22歳,男性。両側陰嚢内容の腫脹を主訴に来院した。受診時に精巣は腫大し,弾性硬で圧痛は認めなかった。腫瘍マーカーはLDH 553IU/l,アルファフェトプロテイン521.8ng/ml,β-ヒト絨毛性ゴナドトロピン2.04ng/mlと高値を示し,画像診断では左右とも精巣は腫大し,内部不均一な像を示した。両側精巣腫瘍と診断し,両側高位精巣摘除術を施行,病理組織では両側同組織型の成熟奇形腫と胎児性癌の複合組織型の診断であった。顕微鏡的脈管内浸潤が認められたため,BEP療法を施行した。
A case of synchronous bilateral testicular tumors of germ cell origin is reported in a 22-year-old man with bilateral testicular swelling. Bilateral high orchiectomy was per-formed.Histological examination of both resected testes revealed mixed type of mature teratoma and embryonal carcinoma. Postoperatively prophylactic chemotherapy was performed because of histological vascular invasion.The patient is doing well after 8 months of postoperative follow-up without any signs of metastasis. A total of 184cases of bilateral testicular germ cell tumors in the Japanese literature are reviwed.
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