Umekawa T, Kurita T
Department of Urology, Kinki University School of Medicine, Osaka, Japan.
Urol Int. 1995;55(4):215-7. doi: 10.1159/000282790.
We report a rare case of malignant mesothelioma of the tunica vaginalis testis. A 67-year-old man was hospitalized with a complaint of swelling on the right side of the scrotal contents. Right high orchiectomy was performed, and the pathological examination revealed malignant mesothelioma of the tunica vaginalis testis. The surgery was thought to have been radical, but 4 months postoperation, local recurrence in the inguinal skin and distant metastasis in the para-aortic lymph node were found. The tumors were treated by surgical resection and radiation therapy. Two months after the second treatment, multiple lung metastasis and a second local recurrence in the inguinal skin were found. High-dose chemotherapy with cisplatin and doxorubicin was performed, but no change was confirmed after 4 weeks. The disease progressed, resulting in death within 8 months of diagnosis. The response of mesothelioma to chemotherapy is thought to be poor histologically as indicated by this case and previously reported cases, so initial radical surgery and adjuvant procedures soon after diagnosis are necessary to achieve cure.
我们报告一例罕见的睾丸鞘膜恶性间皮瘤病例。一名67岁男性因阴囊内容物右侧肿胀而住院。实施了右侧高位睾丸切除术，病理检查显示为睾丸鞘膜恶性间皮瘤。手术被认为是根治性的，但术后4个月，发现腹股沟皮肤局部复发以及主动脉旁淋巴结远处转移。对肿瘤进行了手术切除和放射治疗。第二次治疗两个月后，发现多发肺转移以及腹股沟皮肤再次局部复发。进行了顺铂和阿霉素的大剂量化疗，但4周后未见变化。疾病进展，在诊断后8个月内死亡。如本病例及先前报道的病例所示，从组织学角度来看，间皮瘤对化疗的反应被认为较差，因此诊断后尽早进行初始根治性手术和辅助治疗对于实现治愈是必要的。
