精巣鞘膜腔内中皮嚢胞

Mesothelial Cyst in the Cavum Tunica Vaginalis Testis

　症例は60歳，男性。主訴は左陰嚢腫大であつた。初診時に左陰嚢腫大を認め，超音波検査にて多房性の水瘤を認めたため，陰嚢内多房性水瘤の診断にて入院した。入院後の諸検査にても同様の診断にて，多房性精液瘤や多房性陰嚢水腫を考えて試験開嚢術を施行した。水瘤の剥離は比較的容易で明らかに多房性で，その起始部は精巣上体頭部にあると考えられた。起始部にて結紮切断し，摘出した。水瘤の内容液には精子を多数認め，臨床的には多房性精液瘤と診断したが，病理学的には水瘤の表面は中皮細胞が主体で，嚢胞との診断にて最終的に精巣鞘膜腔内中皮嚢胞と診断した。

A 60-year-old man with a mesothelial cyst in the cavum tunica vaginaris testis is presented. A chief complaint was left scrotal swelling and multilocular cystic mass was demonstrated by ultrasonography, CT and MRI near the head of the epididymis.Clinical diagnosis was spermatocele and spermatocelectomy was performed, Cystic fluid was aspirated and was 80ml (the biggest cystic volume was 35ml), and contained spermatozoa. Pathological diagnosis was mesothelial cyst. We suspected a communication between the mesothelial cyst and epididymis.