Bilateral Malignant Mesothelioma of Tunica Vaginalis A Case Report on Rare Presentation

Our plain-English summary of Bilateral Malignant Mesothelioma of Tunica Vaginalis A Case Report on Rare Presentation, by A.A. Shaikh, K.V. Naik, S.N. Shetty, et al (Urology Case Reports, 2017).

The study

• Authors: A.A. Shaikh, K.V. Naik, S.N. Shetty, N.N. Ansari, P.S. Babhale
• Journal: Urology Case Reports
• Published: 2017;14:53-55
• Type of article: Case report
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Malignant mesothelioma involving the para-testicular tunica is extremely rare and an aggressive tumor. Bilateral malignant mesothelioma of the tunica vaginalis is not reported previously in the literature. Rarity of the disease, absence of any specific clinical and radiological findings makes the preoperative diagnosis difficult. Aggressive surgical approach is the key to successful management with high inguinal orchiectomy and scrotectomy appears to be optimal treatment in patients with localized disease.

In plain English

This article was a case report from a nursing home and endoscopy centre in Navi Mumbai, India. It described one 65-year-old man with painless swelling on both sides of the scrotum that had slowly grown over six months. The report stated he had no environmental or occupational exposure to asbestos. Ultrasound showed masses on both sides arising from the tunica vaginalis, the lining around the testes. Testicular tumor markers were normal. The right testis and half of the scrotum were removed first. Tissue examination and staining confirmed a malignant biphasic mesothelioma of the tunica vaginalis, meaning a tumor with both epithelial and sarcomatous parts. The left side was then removed and showed similar findings. A later PET scan showed no remaining disease. The man had no chemotherapy or radiotherapy and was closely observed. PET scans showed no recurrence or spread at 24 months. The authors concluded that this tumor should be considered when evaluating a tumor in the scrotum outside the testis with normal tumor markers, regardless of asbestos exposure, and they recommended early, aggressive surgery.

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 65-year-old man with bilateral scrotal swellings, reported by authors at Naik Nursing Home & Endoscopy Centre, Navi Mumbai, India; no dates of treatment given
• Exposure: No known asbestos exposure; the report states environmental and professional exposure to asbestos was not present
• Main results:
  • Ultrasound of both testes showed masses arising from the tunica vaginalis, compressing and infiltrating the testicular tissue
  • Testicular tumor markers (alpha-fetoprotein, beta human chorionic gonadotropin) were within normal limits
  • The right-side tumor, removed by high inguinal orchidectomy with hemiscrotectomy, was biphasic, with epithelial and sarcomatous elements
  • Tumor cells were positive for calretinin, cytokeratin 5, 6, 7, vimentin and epithelial membrane antigen, and negative for carcino-embryonic antigen and estrogen and progesterone receptors, confirming malignant biphasic mesothelioma of the tunica vaginalis
  • The left side, removed later by the same operation, showed a similar histological and immunohistochemical profile
  • The patient chose close observation without chemotherapy or radiotherapy. PET scans were negative for local recurrence or distant metastases at 24 months
• The authors' conclusion: The authors concluded that paratesticular malignant mesothelioma should be considered in the differential diagnosis of extratesticular tumors in the scrotum with normal tumor markers, irrespective of asbestos exposure, and recommended an early and aggressive surgical approach

Topics

Medical terms in this study, explained in our Lexicon: Bilateral, Malignant Mesothelioma, Tunica Vaginalis, Orchiectomy.

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