[A CASE OF TESTICULAR TUMOR DIAGNOSED DUE TO ACUTE SCROTUM].

Tadashi Onohara, Hiroki Shirakawa, Toshihiko Tsujii, Ayumu Matsuda
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Abstract

A 32-year-old man visited the emergency department complaining of the right scrotal pain, which occurred suddenly during sexual intercourse. Palpation revealed induration and tenderness on the caudal side of the right testis. Ultrasonography revealed a mosaic-like mass on the caudal side of the testis and no difference in blood flow between the right and left testes. The patient underwent a thorough examination the next day. Although the blood test did not show elevated tumor marker levels, testicular MRI revealed a mass with heterogeneous signal in the right scrotum. Subsequently, the patient was referred to another hospital for surgery. The pathological examination revealed a mixed germ cell tumor: seminoma (60%), teratoma (20%), and embryonal carcinoma (20%). One year postoperatively, the patient has had no recurrence. Testicular tumors are rarely discovered in acute scrotum, and few such cases have been reported. Torsion of the tumor, hemorrhage, necrosis, rupture, and infection have been reported as mechanisms of occurrence. When acute scrotum is diagnosed, testicular tumor should be considered as a differential diagnosis.

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[一例因急性阴囊炎确诊的睾丸肿瘤]。
一名 32 岁男子到急诊科就诊,主诉右侧阴囊疼痛,是在性交时突然发生的。触诊发现右侧睾丸尾部有压痛。超声波检查显示,睾丸尾侧有一个马赛克样肿块,左右睾丸的血流没有差异。第二天,患者接受了全面检查。虽然血液检查未显示肿瘤标志物水平升高,但睾丸磁共振成像显示右侧阴囊有一个信号不均的肿块。随后,患者被转到另一家医院进行手术。病理检查显示为混合性生殖细胞肿瘤:精原细胞瘤(60%)、畸胎瘤(20%)和胚胎癌(20%)。术后一年,患者没有复发。睾丸肿瘤很少在急性阴囊中发现,此类病例的报道也很少。据报道,肿瘤扭转、出血、坏死、破裂和感染是其发生机制。当确诊为急性阴囊炎时,应将睾丸肿瘤作为鉴别诊断。
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