化学療法後残存腫瘍を大動脈合併切除・血行再建により完全切除しえたセミノーマ

A seminoma which was able to completely resect residual tumor post chemotherapy with aortic resection and replacement

　症例は37歳，男性。腹部腫瘤に対し針生検を施行，セミノーマの診断で，当科に紹介され入院した。左側精巣に硬結を触知したため高位精巣摘除術を施行，組織診断はセミノーマであった。病期ⅡBの診断で，合計7コースのVIPおよびTIN化学療法を施行，腫瘍マーカーが正常化したため，残存腫瘍を大動脈とともに合併切除，Y字人工血管により血行再建した。切除組織に腫瘍細胞を認めなかった。術後11か月現在再発を認めず経過観察中である。本邦において，化学療法後の残存腫瘍を腹部大動脈と合併切除・血行再建した精巣腫瘍症例は，筆者らの調べえた限りでは今までに1例の報告のみで，本例は第2例目と思われる。

A 37 years old man was admitted to our department because of seminoma diagnosed by needle biopsy for a huge abdominal mass. Left orchiectomy was performed as his left testis was hard,which was pathologically seminoma. Under the clinical diagnosis of StageⅡB seminoma,he received seven cycle chemotherapy. Because of normalization of tumor marker,he underwent resection of retroperitoneal residual mass in the size of 6.4×2.8cm,together with abdominal aorta and replacement of an artificial blood vessel. Pathological examination revealed no viable cell within resected mass. The postoperative course was uneventful without recurrence for eleven months after the operation. To our knowledge,this case seems the second case of the testicular tumor with resection of residual mass and aortic replacement after chemotherapy in Japan.