Incidentally discovered malignant mesothelioma of the tunica vaginalis

Our plain-English summary of Incidentally discovered malignant mesothelioma of the tunica vaginalis, by C.H. Weng, P.Y. Ho, C.K. Chen, et al (Journal of the Formosan Medical Association = Taiwan Yi Zhi, 2013).

The study

• Authors: C.H. Weng, P.Y. Ho, C.K. Chen, W.K. Tsai
• Journal: Journal of the Formosan Medical Association = Taiwan Yi Zhi
• Published: 2013;112(1):57-8
• Type of article: Case report
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

This letter from Taiwan described a malignant mesothelioma of the tunica vaginalis that was found unexpectedly during hydrocele surgery. A 28-year-old office worker with no history of asbestos exposure was admitted with left scrotal tenderness and swelling that had lasted several weeks. Ultrasonography showed a left hydrocele. During hydrocelectomy, several small papillary lesions about 0.3 to 0.5 cm across were found on the tunica vaginalis near the epididymis. Pathology suggested diffuse papillary mesothelioma, and abdominal CT showed no lymph node or distant spread. After left radical orchiectomy, pathology showed a 2.5 cm grayish papillary tumor and small tumors in the tunica vaginalis, invading paratesticular tissue. The tumor cells were positive for calretinin and cytokeratin 5/6 and negative for Leu-M1 and carcinoembryonic antigen. This confirmed a diffuse tubulopapillary malignant mesothelioma. The authors noted that about 223 cases had been reported worldwide, accounting for around 0.3 to 1.4% of malignant mesotheliomas, and that asbestos exposure had been identified in one-third of cases. They cited a review of 73 cases that reported local recurrence in 35.7% of patients after resection of the hydrocele wall alone, compared with 10.5% after scrotal orchiectomy and 11.5% after inguinal orchiectomy. The patient had no recurrence during twelve months of follow-up without adjuvant therapy. The authors concluded that an unexpected tumor seen at hydrocelectomy needs thorough investigation to determine treatment and prognosis.

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 letter, by authors at Mackay Memorial Hospital in Taipei, Taiwan, described one patient: a 28-year-old office worker with several weeks of left scrotal tenderness and swelling. The article stated he had no history of asbestos exposure. Ultrasound showed a left hydrocele (fluid around the testis). During surgery to remove it, small papillary lesions about 0.3 to 0.5 cm across were found on the tunica vaginalis, the lining around the testis. Pathology first suggested diffuse papillary mesothelioma. An abdominal CT scan showed no lymph node involvement or distant spread. After removal of the left testis (radical orchiectomy), pathology found a 2.5 cm grayish papillary tumor and small tumors in the tunica vaginalis that had invaded nearby tissue. Stains were positive for calretinin and cytokeratin 5/6 and negative for Leu-M1 and carcinoembryonic antigen. The diagnosis of diffuse tubulopapillary malignant mesothelioma of the tunica vaginalis was confirmed. No recurrence was found over the next twelve months without additional treatment after surgery. The authors concluded that an unexpected tumor seen during hydrocele surgery needs thorough investigation to determine treatment and prognosis.

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 (published as correspondence)
• Who was studied: one 28-year-old male office worker with left scrotal tenderness and swelling for several weeks. The authors are from Mackay Memorial Hospital, Taipei, Taiwan.
• Exposure: The article states the patient had no history of asbestos exposure.
• Main results:
  • Scrotal ultrasound showed a left hydrocele.
  • During hydrocelectomy, several small papillary lesions about 0.3 to 0.5 cm in diameter were found on the tunica vaginalis near the epididymis. Pathology suggested diffuse papillary mesothelioma of the tunica vaginalis.
  • Abdominal CT showed no evidence of lymph node involvement or distant metastasis.
  • After left radical orchiectomy, pathology reported a 2.5 cm grayish papillary tumor and small tumors in the tunica vaginalis.
  • Under the microscope, the tumor cells had invaded the tissue next to the testis.
  • Immunohistochemistry was positive for calretinin and cytokeratin 5/6 and negative for Leu-M1 and carcinoembryonic antigen. Diffuse tubulopapillary malignant mesothelioma of the tunica vaginalis was confirmed.
  • No disease recurrence was found during the following twelve months without adjuvant therapy.
• The authors' conclusion: The authors concluded that an unexpected tumor seen at hydrocelectomy needs thorough investigation to determine treatment and prognosis.

Topics

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

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Tunica Vaginalis, Hydrocele, Asbestos Exposure, Hydrocelectomy, Epididymis, Pathology, Well-Differentiated Papillary Mesothelioma.

Related studies

• Is serum hyaluronic acid level useful for evaluating the clinical course of malignant mesothelioma of the tunica vaginalis? — K. Haga, N. Shinohara, et al. (1999)
• Malignant mesothelioma of tunica vaginalis testis — G. Tyagi, C.S. Munn, et al. (1989)
• Malignant mesothelioma of the tunica vaginalis testis: unusual sonographic appearance — M.T. Wang, C.W. Mak, et al. (2005)
• Radiologic findings of mesothelioma at the tunica vaginalis — S.W. Doo, K.H. Cho, et al. (2012)
• Malignant mesothelioma of the tunica vaginalis: a atypical presentation of a rare scrotal tumour — M.C. Harris, C. Logan, et al. (2019)
• Well-differentiated papillary mesothelioma of tunica vaginalis testis of unknown malignant potential: Sonographic appearance — K.W.S. Ko, K.S. Tse, et al. (2018)

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