Takaoka Naoto, Kobori Go, Megumi Yuzuru, Shinmura Kazuya, Hasegawa Tadashi, Moroi Seiji
The Department of Urology, Hamamatsu Rosai Hospital.
The Department of Tumor Pathology, Hamamatsu University School of Medicine.
Hinyokika Kiyo. 2019 Dec;65(12):529-532. doi: 10.14989/ActaUrolJap_65_12_529.
A74-year-old man was referred to the department of general surgery in our hospital because of a painless right scrotal swelling persisting for three months. On physical examination, the patient was found to have an inguinal hernia. The patient underwent laparoscopic transabdominal preperitoneal repair, but no inguinal hernia was detected. The patient was referred to our department for a suspected tumor of the spermatic cord. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a clearbordered and homogeneous mass without fat in the right spermatic cord. The findings from the imaging indicated that the mass was benign, but we suspected a malignant tumor because of the rapid enlargement. We performed a right high orchiectomy with a wide excision. Histopathological diagnosis was dedifferentiated liposarcoma with a myxofibrosarcoma-like pattern. He is alive one year after surgery with no recurrence. When a spermatic cord tumor is detected, we need to keep in mind the possibility of malignancy, because it is difficult to make a diagnosis from imaging alone.
一名74岁男性因右侧阴囊无痛性肿胀持续3个月而被转诊至我院普通外科。体格检查发现该患者患有腹股沟疝。患者接受了腹腔镜经腹腹膜前修补术，但未检测到腹股沟疝。该患者因疑似精索肿瘤被转诊至我科。计算机断层扫描（CT）和磁共振成像（MRI）显示右侧精索有一个边界清晰、均匀的肿块，无脂肪成分。影像学检查结果表明该肿块为良性，但由于其迅速增大，我们怀疑是恶性肿瘤。我们进行了右侧高位睾丸切除术并广泛切除。组织病理学诊断为去分化脂肪肉瘤，呈黏液纤维肉瘤样形态。术后一年他仍存活，无复发。当检测到精索肿瘤时，我们需要牢记恶性的可能性，因为仅靠影像学很难做出诊断。
