A case of mesothelioma of the tunica vaginalis testis, with involvement of the pleura and peritoneum

Our plain-English summary of A case of mesothelioma of the tunica vaginalis testis, with involvement of the pleura and peritoneum, by A. Poggi, F. Longo, G. Mansueto, et al (Tumori, 2000).

The study

• Authors: A. Poggi, F. Longo, G. Mansueto, R. Scirocchi, L. De Petris, D. Gemma, A. Borgomastro, P. Marchei
• Journal: Tumori
• Published: 2000;86(3):256-7
• Type of article: Case report
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

The authors, from a clinical oncology unit in Rome, Italy, reported a case of mesothelioma that originated in the tunica vaginalis testis and also involved the pleura and peritoneum. The patient was a 47-year-old white man with a history of professional exposure to asbestos. He was admitted with a hydrocele and a right paratesticular mass. Surgeons resected the tunica vaginalis and removed the mass completely. Pathology first showed an epithelioid tumor with cytokeratin-positive cells and a high proliferation index. About a month after surgery he returned with abdominal pain and swelling. Examination found ascites, a pleural effusion and a painful paratesticular mass. Cytology of fluid drawn from the abdomen (paracentesis) showed malignant mesothelial cells. When the original specimen was reassessed, the tumor had both epithelioid and fusocellular cell types, and its immunohistochemical profile led to a diagnosis of mesothelioma. CT scanning showed multiple areas of pleural thickening with effusion, a single liver metastasis, and ascites with peritoneal, omental and mesenteric thickening. He received three cycles of cisplatin, adriamycin and cyclophosphamide (PAC), after which the ascites had increased. Two cycles of second-line adriamycin and ifosfamide followed, causing severe pancytopenia. He later had an intestinal obstruction that resolved with medical treatment. He died eight months after the operation. The authors noted that involvement of three serous membranes has rarely been reported. They concluded that cytological examination of hydrocele fluid followed by radical surgery (hemiscrotectomy) is the most important approach, and that patients should be entered in trials of new drugs.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This article was a case report of one patient treated at a clinical oncology unit in Rome, Italy. A 47-year-old white man with a history of work exposure to asbestos was admitted with a hydrocele (fluid around the testis) and a mass beside the right testis. The mass was completely removed by surgery. About a month later the patient returned with fluid in the abdomen, fluid around the lung and a painful mass beside the testis. Fluid drawn from the abdomen contained malignant mesothelial cells. Re-examination of the removed tissue showed two cell types, epithelioid and fusocellular, and the authors diagnosed mesothelioma that started in the tunica vaginalis testis and also involved the pleura and peritoneum. A CT scan showed pleural thickening, a single liver metastasis and abdominal spread. Three cycles of chemotherapy were followed by increased abdominal fluid. Two cycles of second-line chemotherapy caused severe drops in blood cells. The patient died eight months after the operation. The authors concluded that patients with these rare tumors should be entered in clinical trials of new drugs.

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 (one patient)
• Who was studied: one 47-year-old white man treated at Policlinico Umberto I, Rome, Italy; dates of treatment not given
• Exposure: a history of occupational (professional) exposure to asbestos; no fiber type, job or dose is given
• Main results:
  • The patient was hospitalized for a hydrocele with a right paratesticular mass, and the mass was completely removed by surgical resection of the tunica vaginalis
  • About a month after surgery the patient returned with abdominal pain and swelling; examination found ascites, a right pleural effusion and a painful paratesticular mass
  • Cytology of abdominal fluid drawn by paracentesis was positive for malignant mesothelial cells
  • On reassessment, the removed tumor had two cell types, epithelioid and fusocellular, and its staining features led to a diagnosis of mesothelioma
  • A CT scan showed multiple pleural thickening with a left basal effusion, a single liver metastasis, and ascites with peritoneal, omental and mesenteric thickening
  • After three cycles of first-line chemotherapy (cisplatin, adriamycin and cyclophosphamide), CT showed increased ascites
  • Two cycles of second-line chemotherapy (adriamycin, ifosfamide and MESNA) were given, with severe pancytopenia requiring blood transfusion and growth-factor support
  • The patient had an intestinal obstruction that resolved with medical treatment and died eight months after the operation
• The authors' conclusion: The authors concluded that, because these rare tumors resist radiotherapy and chemotherapy, patients should be entered in clinical trials of new drugs. They also wrote that preoperative diagnosis is feasible by cytological examination of every patient with hydrocele, regardless of age.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma, Peritoneal mesothelioma.

Medical terms in this study, explained in our Lexicon: Mesothelioma, Tunica Vaginalis, Pleura, Peritoneum, Hydrocele, Paratesticular, Pathology, Epithelioid.

Related studies

• Concomitant malignant mesothelioma of the pleura, peritoneum, and tunica vaginalis testis — V. Ascoli, F. Facciolo, et al. (1996)
• Malignant mesothelioma of the tunica vaginalis testis: a rare case and review of literature — M. Drevinskaite, A. Patasius, et al. (2020)
• Malignant mesothelioma of the tunica vaginalis testis related to recent asbestos — Y. Ikegami, N. Kawai, et al. (2008)
• Cutaneous Metastases From Malignant Mesothelioma of the Tunica Vaginalis Testis — P. Hispán, J.C. Pascual, et al. (2016)
• 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)

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