Case Report of a Well-Differentiated Papillary Mesothelioma of the Tunica Vaginalis in an Undescended Testis With Review of Literature

Our plain-English summary of Case Report of a Well-Differentiated Papillary Mesothelioma of the Tunica Vaginalis in an Undescended Testis With Review of Literature, by P. Parcesepe, S. Sina, C. Zanella, et al (International Journal of Surgical Pathology, 2016).

The study

• Authors: P. Parcesepe, S. Sina, C. Zanella, M. Pancione, J. Giuliani, P. Detogni, P. Curti, A. Bonetti, E. Manfrin, A. Remo
• Journal: International Journal of Surgical Pathology
• Published: 2016;24(5):443-7
• Type of article: Case report, Review
• Cited by: 6 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Well-differentiated papillary mesothelioma (WDPM) affecting the tunica vaginalis testis is a rare tumor, and very little is known about the clinicopathological spectrum of this variant as a distinct entity. Most patients with WDPM suffer from scrotal pain or swelling, but hydrocele seems to be the most common presenting symptom. These lesions are usually not aggressive and are accompanied by an indolent clinical behavior. In this article, we report the first case known of WDPM in an undescended testis, and in addition, we review the literature for similar cases.

© The Author(s) 2016.

In plain English

This article is a case report combined with a review of earlier published cases. The authors described a 26-year-old man admitted in April 2013 to the "Mater Salutis" Hospital in Legnago, Italy. A routine ultrasound had found an unexpected solid-cystic mass in an undescended testis that lay inside the abdomen. His medical history showed no exposure to asbestos or ionizing radiation. Surgeons removed the testis together with a paratesticular cyst 48 mm across. Under the microscope the tumor was a well-differentiated papillary mesothelioma (WDPM) of the tunica vaginalis. Its cells showed mild or absent atypia, with no mitoses (dividing cells) or necrosis, and stains for mesothelial markers were positive. The patient had no further treatment and was free of disease after 29 months of follow-up. In the published cases the authors reviewed, patients were aged 18 to 70 years (mean 43), and hydrocele was reported in 82% of cases. The authors described this as, to their knowledge, the first case of WDPM in an undescended testis. They concluded that only long-term follow-up will show how this rare tumor behaves.

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 of one patient, with a review of previously published cases
• Who was studied: One 26-year-old man admitted in April 2013 to the Mater Salutis Hospital, Legnago, Italy. The literature review covered earlier published cases of WDPM of the tunica vaginalis and 9 published cases of mesothelioma of tunica vaginalis of uncertain malignant potential (MUMP).
• Exposure: The patient's history revealed no exposure to asbestos or ionizing radiation. The article does not study any asbestos exposure.
• Main results:
  • A routine ultrasound found an unexpected solid-cystic mass in an undescended testis inside the abdomen.
  • After surgical removal, the specimen showed a paratesticular cyst 48 mm in diameter attached to a testis measuring 5 by 2.5 by 1.5 cm.
  • Most tumor cells showed mild or absent atypia, and no mitoses or necrosis were seen.
  • Tumor cells were positive for CA125, calretinin, CK7, CK 5/6 and WT-1, and negative for CEA, CD10, CDX-2, CK20 and TTF1.
  • The patient received no medical therapy after surgery and was well and free of disease at 29 months of follow-up.
  • In the reviewed cases of WDPM of the tunica vaginalis, patients' ages ranged from 18 to 70 years (mean 43 years).
  • In the reviewed cases, hydrocele was the most common presenting symptom, reported in 82% of cases.
  • The authors also summarized 9 published cases of mesothelioma of tunica vaginalis of uncertain malignant potential (MUMP).
• The authors' conclusion: The authors reported what they believe is the first known case of WDPM in the tunica vaginalis of an undescended testis, with no residual disease or local progression 29 months after surgery. They concluded that only long-term follow-up will fully show how this rare variant behaves biologically.

Topics

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

Medical terms in this study, explained in our Lexicon: Well-Differentiated Papillary Mesothelioma, Tunica Vaginalis, Hydrocele.

Related studies

• Well-differentiated papillary mesothelioma of tunica vaginalis testis of unknown malignant potential: Sonographic appearance — K.W.S. Ko, K.S. Tse, et al. (2018)
• Well-Differentiated Papillary Mesothelioma of the Tunica Vaginalis: Case Report and Systematic Review of Literature — W.K. Tan, M.Y. Tan, et al. (2016)
• Well differentiated (benign) papillary mesothelioma of the tunica vaginalis — R. Chetty (1992)
• Well-differentiated Papillary Mesothelioma of the Tunica Vaginalis — W.K. Tan, M.Y. Tan, et al. (2016)
• Well-differentiated papillary mesothelioma of the tunica vaginalis: a case study and review of the literature — S. Erdogan, A. Acikalin, et al. (2014)
• Papillary serous carcinoma of the tunica vaginalis testis — P. Becerra, M.A. Isaac, et al. (2000)

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