Fibrous mesotheliomas (pseudofibroma) of the scrotal sac: a light and ultrastructural study

Our plain-English summary of Fibrous mesotheliomas (pseudofibroma) of the scrotal sac: a light and ultrastructural study, by B. Benisch, B. Peison, H.J. Sobel, et al (Cancer, 1981).

The study

• Authors: B. Benisch, B. Peison, H.J. Sobel, E. Marquet
• Journal: Cancer
• Published: 1981;47(4):731-5
• Type of article: Case report
• Cited by: 25 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy.

Abstract

Fibrous mesotheliomas of the scrotal sac are described. Similar tumors have been previously reported as fibromas and pseudofibromas and have been considered to be non-neoplastic, reactive, fibrous lesions. Ultrastructural evidence for a mesothelial origin for these tumors is presented. The value of ultrastructural study in the classification of tumors arising in or on mesothelial lined surfaces is stressed.

In plain English

This case report described one 64-year-old white man who had had a scrotal mass for two years. At operation, 5 separate masses were found that appeared to arise from the tunica vaginalis and were confined to the scrotal sac. The testis and spermatic cord were not involved. The largest mass measured 14 x 10 x 5 cm and the others 6, 2.5, 2.2 and 2 cm. Under the light microscope the tumors were mostly made of spindle cells with bland nuclei, and mitotic figures were rare. Under the electron microscope, tumor cells showed features the authors described as characteristic of mesotheliomas: microvilli, a basal lamina, rudimentary desmosomes, tight junctions and cytoplasmic filaments. The authors were persuaded the tumor was of mesothelial origin. They wrote that its appearance suggested a true neoplasm, but that a reactive mesothelial proliferation could not be excluded. The patient was free of disease 8 months after surgery. The authors suggested asbestos may play a role in some such scrotal tumors. However, this patient did not have an occupational or residential history consistent with asbestos exposure.

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 light and electron microscopic study of the excised tumors
• Who was studied: One 64-year-old white man with a scrotal mass of two years' duration. The case report does not name the hospital, though the authors were based at Rahway Hospital and the Veterans Administration Medical Center, East Orange, New Jersey.
• Exposure: No asbestos exposure was studied. The authors report the patient did not have an occupational or residential history consistent with asbestos exposure.
• Main results:
  • Surgery found 5 well-circumscribed nodules in the patient's scrotal sac that appeared to arise from the tunica vaginalis
  • The largest nodule measured 14 x 10 x 5 cm; the others measured 6, 2.5, 2.2 and 2 cm
  • On light microscopy, rare mitotic figures were identified in the tumors
  • On electron microscopy, tumor cells showed microvilli, cytoplasmic filaments and a basal lamina
  • Where tumor cells lay close together, rudimentary desmosomes and tight junctions were identified
  • The authors could not identify transitions between the fibroblastic cells and the cells with mesothelial features
  • The patient remained well and free of disease 8 months after surgery
• The authors' conclusion: The authors were persuaded the tumor was of mesothelial origin. In their view its appearance suggested a true neoplasm, although a reactive mesothelial proliferation could not be excluded.
• Limitations the authors state:
  • The ultrastructural findings were not as striking or well delineated as those in typical biphasic pleural mesothelioma
  • The relationship between the fibroblastic cells and the cells with mesothelial features remained unresolved
  • The tissue was first handled as a routine surgical specimen, although the authors judged fixation adequate

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma.

Related studies

• Scrotal peritoneal mesothelioma on PET/CT — S. Ozguven, M. Aras, et al. (2014)
• Paratesticular mesotheliomas — R.E. McDonald, A.L. Sago, et al. (1983)
• Sonography of intrascrotal adenomatoid tumor — W.C. Leonhardt, G.A. Gooding (1992)
• Paratesticular tumors. A clinicopathological study from a single tertiary hospital in North India — P.A.M. Paul, N. Calton, et al. (2021)
• Cystic lymphangioma: an uncommon type of scrotal swelling — G. Ferguson (1954)
• Malignant mesothelioma of the tunica vaginalis: a atypical presentation of a rare scrotal tumour — M.C. Harris, C. Logan, et al. (2019)

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