精巣腫瘍との鑑別が困難であったアデノマトイド腫瘍

A Case of Adenomatoid Tumor Mimicking Testicular Carcinoma

　患者は52歳，男性。左陰嚢内の疼痛を伴う硬結を主訴に当科を初診した。左精巣腫瘍の診断のもと手術が施行された。肉眼的には精巣上体に腫瘍は認められず，精巣内に固く腫瘍を触れたため，精巣腫瘍と判断し高位除睾術を施行した。組織学的に腫瘍は大小の腔を形成して増殖し，腔に面して扁平ないし立方形細胞が配列し，アデノマトイド腫瘍と診断された。病変の分布は精巣内に広くみられたが，精巣上体にも及んでいた。

The patient was a 52-year-old man with a left scrotal nodule with pain. Serum levels of tumor markers (HCG-β and AFP) were within normal limits. The patient un-derwent operation to determine the nature of the nodule. As the nodule was located inside the testis, left high orchidectomy was performed under the diagnosis of the left testicular tumor. Microscopically the tumor was com-posed of epithelium-like cells and fibrous stroma, which led the diagnosis of adenomatoid tumor spread in the epididymis, testicular tunica albuginea and the testis. Adenomatoid tumor in the testis is extremely rare.