Malignant mesothelioma of the spermatic cord

Our plain-English summary of Malignant mesothelioma of the spermatic cord, by Y.J. Park, H.J. Kong, H.C. Jang, et al (Korean Journal of Urology, 2011).

The study

• Authors: Y.J. Park, H.J. Kong, H.C. Jang, H.S. Shin, H.K. Oh, J.S. Park
• Journal: Korean Journal of Urology
• Published: 2011;52(3):225-9
• Cited by: 15 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Primary tumors arising from the spermatic cord are very rare. Mesothelioma derives from the mesothelial cells lining the serous membrane, such as the pleura, peritoneum, and tunica vaginalis of testis. Paratesticular malignant mesothelioma (MM), which usually presents as a hydrocele or intrascrotal mass, accounts for 0.3% to 1.4% of MMs. MMs of the spermatic cord account for less than 10% of paratesticular MMs. We report a case of MM of the spermatic cord in a 65-year-old man who primarily presented to the hospital with a left inguinal mass. Following the diagnosis after surgery, he was found to have a contralateral right inguinal mass and died in 6 months. Despite their rare occurrence in the spermatic cord, MMs need to be suspected, especially in patients with a history of asbestos exposure.

In plain English

This case report from the Catholic University of Daegu, Korea, described one man with malignant mesothelioma arising from the spermatic cord. The 65-year-old man came to the clinic with a painless lump in his left groin that had been present for 2 months. He had worked for 4 years at a foundry 10 years earlier, and the authors reported that he had been exposed to asbestos for 4 years. The article did not name a fiber type. Surgeons removed his left testis and spermatic cord, which held a 5.0x3.2x2.5 cm mass, plus three small nodules from the abdominal lining. Tissue tests were compatible with malignant mesothelioma of the left spermatic cord. He declined further surgery and chemotherapy. Three months later a 1.8 cm nodule appeared in his right groin, and tumor had spread across the abdominal lining with fluid buildup. He had one cycle of chemotherapy given into the abdomen, with some improvement, and died 6 months after the operation. The authors concluded that this tumor should be suspected, especially in patients with a history of 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 (one patient)
• Who was studied: One 65-year-old man seen at the Department of Urology, Catholic University of Daegu School of Medicine, Daegu, Korea, with a painless left groin (inguinal) mass present for 2 months
• Exposure: 4 years of employment at a foundry 10 years before presentation, which the authors described as 4 years of asbestos exposure. No fiber type, product or dose was given.
• Main results:
  • The patient underwent left radical orchiectomy. A 5.0x3.2x2.5 cm nodular mass was found on the left spermatic cord, and three small nodules at the peritoneal surface of the internal inguinal ring were excised.
  • The tumor contained epithelial and sarcomatous cells. These were immunoreactive to cytokeratin, calretinin, vimentin and HBME-1 but not to CEA. The findings were compatible with malignant mesothelioma arising from the left spermatic cord.
  • The peritumoral resection margin was partially penetrated by tumor. The cord resection margin was free of tumor, and no lymphovascular invasion was seen.
  • The patient refused the recommended pelvic lymphadenectomy and adjunctive chemotherapy.
  • At 3 months after the operation, CT showed a 1.8 cm nodule in the right inguinal area, suggesting mesothelioma of the opposite spermatic cord. CT also showed peritoneal carcinomatosis with a large amount of ascitic fluid.
  • He received one cycle of cisplatin-based intraperitoneal chemotherapy with some improvement and died 6 months after the operation.
• The authors' conclusion: The authors concluded that, although rare in the spermatic cord, mesothelioma needs to be suspected, especially in patients with a history of asbestos exposure. They added that more aggressive management, such as a second-look operation with pelvic lymphadenectomy or adjunctive chemotherapy, may be required after diagnosis.

Topics

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Spermatic Cord, Mesothelioma, Mesothelial Cells, Pleura, Peritoneum, Tunica Vaginalis, Paratesticular.

Related studies

• Treatment of malignant tumors of the spermatic cord: a study of 10 cases and a review of the literature — P.H. Blitzer, D.E. Dosoretz, et al. (1981)
• Tumors of the spermatic cord: a review of the literature and a report of a case of lymphangioma — A.A. el-Badawi, M.M. al-Ghorab (1965)
• Mesothelioma of spermatic cord: electron microscopic and histochemical characteristics of its mucopolysaccharides — P. Pizzolato, J. Lamberty (1976)
• Malignant mesotheliomas in spermatic cords: reports of two cases and a brief review of literature — X. Meng, T.J. Guzzo, et al. (2013)
• Malignant Mesothelioma of Spermatic Cord in an Elderly Man With a History of Asbestos Exposure — A. D'Antonio, F. Mastella, et al. (2016)
• Carcinosarcoma of the spermatic cord — M. Nistal, F. Burgos, et al. (1990)

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