副睾丸アデノマトイド腫瘍--日本語文献の概観

アデノマトイド腫蕩は副睾丸腫瘍中最も多くみられるものである。坂口により第1例が発表されて以来44例が報告されている。われわれは比較的筋性成分を豊富に含む45例目を報告する。このような例はアデノマイド腫瘍のうち約3%の割でみられるといわれている。われわれはまた本邦において報告された全文献の概観をも報告する。ABSTRACT: Adenomatoid tumors are the most frequently encountered tumor of the epididymis, and forty-four cases have been reported in Japan since the first case was reported by Sakaguchi. We report the 45th case with relatively abundant leiomyomatous content, a characteristic said to be found in about 3 per cent of adenomatoid tumors. We also report the results of a review of all relevant literature published in this country

Congenital mesoblastic nephroma:症例報告および文献的考察

乳児のongenital esoblastic nephromaは臨床的および病理組織学的な特徴でWilms腫瘍と別の疾患であると考えられるようになって10年以上たっている。しかしこの腫瘍はときにWilms腫瘍と混乱されるために不用意にも現在でもWilms腫瘍のような積極的な治療が行なわれる。れわれは本疾患の文献を考察し，英文および日本語の文献中の91例を解析した。その結果, 適切な術後療法をさけるために切除標本に対して迅速でかつ正確な病理組織学的診断の重要性を述べ，かつcongenital mesoblastic nephromaの特徴を記載した。Congenital mesoblastic nephroma of infancy has been recognized for more than a decade as a different entity from the Wilms' tumor in its clinical and histopathological features. This tumor, however, is sometimes confused with Wilms' tumor and subsequently inadvertent and vigorous therapy compatible with that of Wilms' tumor is done even at present time. We reviewed the pertinent literature and analyzed 91 cases of congenital mesoblastic nephroma in English and Japanese literature. As a result we emphasized the importance of early and accurate histopathological diagnosis of the resected specimen to avoid inappropriate postoperative therapy and characterized the peculiar features of congenital mesoblastic nephroma in this paper

血管撮影で診断された腎癌を原発とする無症候性膵転移の1例

腎癌の隣転移は稀であり，原発巣治療前に切除可能な膵転移が診断されることはさらに稀である。われわれは， 膵体部に転移を伴った腎癌を偶然診断し，腎摘時に膵部分切除および脾摘除術を同時に施行した。術後約9カ月たった現在，患者は健在で紹介病院外来に通院している。本論文では膵転移を伴った腎癌の1例を報告するとともに若干の文献的考察も加えた。The pancreas is uncommon site of metastasis from renal cell carcinoma. It is extremely rare to diagnose renal cell carcinoma with metastasis to the body of the pancreas before surgery. We report such a case diagnosed incidentally on arteriography. Partial pancreatectomy with splenectomy was performed at the time of radical nephrectomy. Reported cases of metastatic renal cell carcinoma to the pancreas are reviewed briefly

精巣胚細胞腫瘍の臨床的検討

精巣胚細胞腫瘍65例68精巣を臨床的に検討した.36精巣(53.7%)はセミノーマで, 残りはnon-seminomatous germ cell testicular tumor(NSGCTT)であった.セミノーマ症例のうち31例(88.6%)はI期でそれ以外は受診時に転移巣を有していた.NSGCTTのうち22例(68.8%)はI期であった.セミノーマ及びNSGCTT症例の平均年齢は各々40.4, 29.2歳であった.39例(60.0%)は右側, 23例(35.4%)は左側, 3例(4.6%)は両側性であった.5例は停留精巣の既往を有していた.49例(73.1%)において主訴は無痛性精巣腫大であった.症状発現から受診迄の期間はNSGCTT症例よりセミノーマの方が長かった(平均10.9ヵ月と3.4ヵ月).Immunosuppressive acidic protein(IAP)はalpha-feto protein(AFP), beta-human chorionic gonadotropin(betahCG), lactic dehydrogenase(LDH)と共に腫瘍マーカーとして有用であったA clinical statistical analysis on 65 patients with 68 testicular germ cell tumors was performed. Thirty-six testes (53.7%) had seminomas and the remainder non-seminomatous germ cell testicular tumors (NSGCTTs). Of the seminomas, 31 (88.6%) were in stage I and the others showed distant metastases at presentation. Of the 32 NSGCTTs, 22 (68.8%) were in stage I. The average ages of the patients with seminomas and NSGCTTs were 40.4 and 29.9 years, respectively. Thirty-nine patients (60.0%) had tumors on the right side, 23 (35.4%) on the left and 3 (4.6%) in both testes. Five patients had a past history of cryptorchidism. Chief complaints in 49 patients (73.1%) were a painless scrotal mass. The interval from clinical onset to presentation was longer in seminoma patients than in NSGCTT patients (10.9 months on average versus 3.4 months). Immunosuppressive acidic protein (IAP) was a useful diagnostic tumor marker as well as alpha-feto protein (AFP), beta-human chorionic gonadotropin (beta-hCG) and lactic dehydrogenase (LDH). We adopted a surveillance policy in more than half of the stage I patients and obtained acceptable results. In the remaining cases, therapies including combination chemotherapy, radiation and salvage operation were performed after orchiectomy. The three-year survival rate was 98.0, 100.0 and 26.7%, for stage I, II and III patients respectively