超音波で診断した陰嚢内非触知精巣腫瘍

Sonographic Detection of Clinically Non Palpable Testicular Cancer with Multiple Lung Metastases and Retroperitoneal Bulky Tumors:A Case Report

　37歳，男性。多数の肺転移腫瘍，後腹膜のバルキイ腫瘍を認め，ヒト絨毛性ゴナドトロピン122,000mlU／ml，β—ヒト絨毛性ゴナドトロピン1,200ng／ml,AFP3.4ng／mlであった。—方，精巣は触診上正常であったが，超音波検査で径12mmの低エコー像を示す腫瘍を認め，左精巣腫瘍と診断し，摘出した。組織は精上皮腫であった。化学療法により一時的に腫瘍マーカーが正常化し，後腹膜リンパ節郭清術を施行したが，その後に肺転移巣の増大，腰椎転移の出現がみられ，初診後33か月目に死亡した。

A 37-year-old man with a complaint of blood tinged sputum, had multiple lung metastatic tumors and retroperitoneal bulky tumors. Both testes were physically normal on palpa-tion, but scrotal sonography revealed a tumor, 12 mm in diameter, in the left testis. Histological diagnosis was seminoma. HCG, β-HCG and AFP levels were 122,000 mIU/ml, 12,000 ng/ml and 3.4ng/ml, respectively. After 4 cycles of BEP and 3 cycles of VIP chemotherapy, tumor markers decreased to normal levels and retroperitoneal lymphoadenectomy was performed.