緩徐な経過を示した精索原発平滑筋肉腫の1例

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33歳男性.患者は左陰嚢部の有痛性腫瘤を自覚するも放置し,再び陰嚢部痛が増強したため,著者らの施設へ受診となった.血液検査では異常所見はなく,超音波検査にて左陰嚢内に長径5cmの内部不均一な充実性腫瘍,長径2cmのlow echoic lesionがみられた.以上より,精巣上体または精索の腫瘍などを疑い,腫瘍摘除術を行った.病理組織学的に精索原発平滑筋肉腫と診断され,左高位精巣摘除術および放射線照射を追加した.術後13ヵ月経過現在,再発転移はみられず,経過良好であるA 33-year-old man referred to our hospital with a painful swelling of the left scrotal content which had gradually enlarged during the past 4 years. Physical examination revealed a hard, irregular, nontender mass of 5x4 cm in the left scrotum. The mass was fixed to the left epididymis and spermatic cord. Local excision was performed and histologcal examination revealed leiomyosarcoma originating from the spermatic cord. Distant metastases were not observed. Because of the reportedly high propensity for local recurrence, we performed radical orchiectomy and adjuvant radiation. The patient has been alive for 13 months with no evidence of disease.