抄録
症例は62歳, 男性.右陰嚢内腫瘤触知を主訴に当科受診.HCG-β2.3ng/mlと高値を示し, 精巣, 精巣上体は腫瘤と一塊になり, 触知しなかった.以上より, 右精巣腫瘍の診断にて高位精巣摘出術を施行した.精巣には軽度萎縮を認めるのみで悪性像は認められず, 精索に腫瘍を認め, 病理組織学的診断は低分化腺癌であった.術後もhCG-βは高値持続し, CEA, CA19-9も高値を呈したため, 胃内視鏡を施行.Borrmann III型の腫瘍を認め, 生検組織の病理組織学的診断は低分化腺癌であった.免疫組織学的に胃, 及び精索の腫瘍は, hCG-β陽性であった.以上より精索の腫瘍は胃癌精索転移と診断され, 全身化学療法施行するも術後10カ月にて死亡した.
A 62-year-old man was presented with a firm mass in right scrotum. Serum LDH and AFP were within normal range, but hCG-β was elevated (2.3ng/ml). Under the diagnosis of right testicular tumor, he underwent right radical orchiectomy. The specimen was a spermatic cord tumor with poorly differentiated adenocarcinoma. hCG-β was still elevated postoperatively and gastric fiber revealed adenocarcinoma of the stomach. Histochemical staining for hCG-β was positive in both tumor of the spermatic cord and stomach. Finally the tumor was diagnosed as metastatic tumor of spermatic cord from gastric cancer, causing the elevation of hCG-β.
