Muraki J, Hashimoto S, Morita T, Kobayashi Y, Nakamura S, Tokue A
Department of Urology, Jichi Medical School, Tochigi, Japan.
Nihon Hinyokika Gakkai Zasshi. 1995 Aug;86(8):1398-401. doi: 10.5980/jpnjurol1989.86.1398.
A 47-year-old man presented with a 10-year history of left scrotal swelling. No solid mass detected on sonogram, dark-red colored fluid aspirated, equivocal cytology, and elevated serum CA19-9 level prompted surgical exploration. Frozen section reported no malignancy of thickening of the tunica vaginalis. The final pathology adenocarcinoma, however, necessitated left radical orchiectomy and hemiscrotal resection, demonstrating no malignancy at the left testis nor epididymis. CA19-9 level was high (104,200 U/ml) in the fluid obtained at the first surgery and the tumor cells were positively stained for CA19-9. Imaging study including abdominal CT scan and upper G-I series and normalization of CA19-9 level denied other tumor existing. In conclusion, this is to our knowledge the first case report of adenocarcinoma of the tunica vaginalis expressing CA19-9 antigen.
一名47岁男性，有10年左侧阴囊肿胀病史。超声检查未发现实性肿块，抽出暗红色液体，细胞学检查结果不明确，血清CA19-9水平升高，遂进行手术探查。冰冻切片报告显示鞘膜增厚无恶性病变。然而，最终病理结果为腺癌，因此进行了左侧根治性睾丸切除术和半阴囊切除术，结果显示左侧睾丸和附睾均无恶性病变。首次手术获取的液体中CA19-9水平较高（104,200 U/ml），肿瘤细胞CA19-9染色呈阳性。包括腹部CT扫描和上消化道造影在内的影像学检查以及CA19-9水平恢复正常排除了其他肿瘤的存在。总之，据我们所知，这是首例表达CA19-9抗原的鞘膜腺癌病例报告。
