精索脂肪平滑筋肉腫の1例

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54歳男性.主訴は左鼠径部腫瘤であった.超音波検査では左鼠径部に境界明瞭な腫瘤を認め,骨盤CTでは左鼠径部に強く造影される腫瘤を認めた.既往歴の検証から腫瘍性病変を第一に考えて,手術を行った.左鼠径部から陰嚢へ向かい切開すると,腫瘤は精索内にあり腫瘍性病変が強く疑われたため,高位精巣摘除術を施行した.切除標本では病理組織学的に良く分化した脂肪細胞,異型性を有する線維芽細胞様細胞や脂肪芽細胞を認め,それらの免疫組織化学的所見より脂肪平滑筋肉腫と診断した.術後7日目に退院し,術後4ヵ月の現在でも転移や再発を認めていないA 54-year-old male was referred to our hospital with the chief complaint of a painless inguinal mass. A hard mass was palpable beside the left spermatic cord, which was covered with a soft tissue mass. Computed tomographic scan showed an inguinal mass, which was well enhanced to vascular density. The operative appearance indicated a tumor in the left spermatic cord, so we performed a radical orchiectomy. Histopathological diagnosis was lipoleiomyosarcoma. Lipoleiomyosarcoma of the spermatic cord is quite rare, and our case was considered as the first report in Japan.