A Bilateral Metachronous Mesothelioma of the Tunica Vaginalis

Our plain-English summary of A Bilateral Metachronous Mesothelioma of the Tunica Vaginalis, by A. Abello, J. Steinkeler, A.K. Das (Urology, 2018).

The study

• Authors: A. Abello, J. Steinkeler, A.K. Das
• Journal: Urology
• Published: 2018;120:e1-e2
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

This is a unique case of bilateral metachronous testicular mesothelioma of the tunica vaginalis. Testicular mesothelioma is a rare entity found in patients with or without asbestos occupational exposure. The tumor most commonly presents as a unilateral testicular mass. More rare presentations include bilateral synchronous or metachronous tumors. Treatment is with surgical resection and prognosis is not generally favorable. The benefits of adjuvant therapy with radiation or chemotherapy remain unknown and further studies are needed.

Copyright © 2018 Elsevier Inc. All rights reserved.

In plain English

This case report describes one man with malignant mesothelioma of the tunica vaginalis, a membrane around the testicle. The tumor appeared first on one side and later on the other. An 80-year-old man came to urology in 2015 with a painless mass in his right testicle. He denied smoking or occupational asbestos exposure. Ultrasound showed a 3.8 cm cystic mass outside the testicle, and tests for spread were negative. After the right testicle was surgically removed, pathology found a 3.1 cm biphasic malignant mesothelioma with sarcomatoid and epitheloid components. It arose from the tunica vaginalis and invaded nearby tissues. He then completed radiation to the scrotum and groin area, and CT scans over the next 2 years showed no distant spread. Twenty-six months after the first operation he returned with left testicular swelling. After the left testicle was removed, pathology found a 1.8 cm sarcomatoid malignant mesothelioma. He refused further systemic therapy and was followed under close surveillance. The authors wrote that the benefits of added radiation or chemotherapy remain unknown and that further studies are needed.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (single patient)
• Who was studied: One 80-year-old man who presented to urology in 2015 with a painless right testicular mass
• Exposure: No asbestos exposure was studied. The patient denied smoking and denied occupational asbestos exposure.
• Main results:
  • Initial scrotal ultrasound showed a 3.8 cm right extratesticular complex cystic mass. Metastatic work-up was negative.
  • After right inguinal orchiectomy, pathology showed a 3.1 cm biphasic malignant mesothelioma with sarcomatoid and epitheloid components.
  • The right-side tumor arose from the tunica vaginalis and invaded the tunica albuginea, hilar and paratesticular soft tissues.
  • The patient completed radiation to the scrotum and inguinal area. Serial torso CT scans over the next 2 years showed no distant metastasis.
  • The patient returned 26 months after the first operation with left testicular swelling.
  • After radical inguinal left orchiectomy, pathology showed a 1.8 cm sarcomatoid malignant mesothelioma with hilar soft tissue extension.
  • The patient refused further systemic therapy and was being followed under close surveillance.
• The authors' conclusion: The authors stated that treatment is surgical resection, that prognosis is not generally favorable, and that the benefits of adjuvant radiation or chemotherapy remain unknown, with further studies needed.

Topics

Medical terms in this study, explained in our Lexicon: Bilateral, Mesothelioma, Tunica Vaginalis, Testicular Mesothelioma, Occupational Exposure, Surgical Resection, Prognosis, Adjuvant Therapy.

Related studies

• Bilateral Malignant Mesothelioma of Tunica Vaginalis A Case Report on Rare Presentation — A.A. Shaikh, K.V. Naik, et al. (2017)
• Malignant mesothelioma of the tunica vaginalis. A clinicopathologic analysis of 11 cases with review of the literature — M.A. Jones, R.H. Young, et al. (1995)
• Malignant mesothelioma of the tunica vaginalis testis: report of first case with preoperative diagnosis — L. Japko, A.A. Horta, et al. (1982)
• Malignant mesothelioma of the tunica vaginalis testis — K. Antman, S. Cohen, et al. (1984)
• Epidemiology of mesothelioma of the pericardium and tunica vaginalis testis — G. Mezei, E.T. Chang, et al. (2017)
• Malignant mesothelioma of the tunica vaginalis testis: diagnostic studies and differential diagnosis — S.S. Chekol, C.C. Sun (2012)

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