Malignant mesothelioma of the tunica vaginalis

Our plain-English summary of Malignant mesothelioma of the tunica vaginalis, by M. Kamiya, T. Eimoto (Pathology, Research and Practice, 1990).

The study

• Authors: M. Kamiya, T. Eimoto
• Journal: Pathology, Research and Practice
• Published: 1990;186(5):680-4; discussion 685-6
• Type of article: Case report, Review
• Cited by: 15 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 003834).

Abstract

A case of a malignant mesothelioma of the tunica vaginalis is presented. The patient with an intrascrotal mass was a 32-year-old Japanese male who had no history of asbestos exposure. The tumor was located on the surface of the right testis and was composed of columnar to polygonal cells with glandular and papillary structures. It showed many mitoses and focal invasion of the tunica albuginea. The tumor cells contained alcian blue- and Hale's colloidal iron-positive, hyaluronidase-digestible materials. Immunohistochemical stains for cytokeratin and vimentin were positive, while those for carcinoembryonic antigen, epithelial membrane antigen, Leu-M1, and factor VIII-related antigen were negative. The systemic examinations revealed no other tumors. Based on these findings the tumor was diagnosed as malignant mesothelioma of the tunica vaginalis. The differential diagnosis is discussed under the histologic, histochemical, and immunohistochemical points of view and the previous literature is reviewed.

In plain English

This article was a case report of a malignant mesothelioma of the tunica vaginalis, with a review of earlier published cases. The patient was a 32-year-old Japanese man with no history of exposure to asbestos. He had noticed a small tumor in his right scrotum six months before coming to the hospital. His right testis was removed. A 1 x 1 x 1 cm tumor lay in the tunica vaginalis on the lower surface of the testis. It invaded the tunica albuginea and showed numerous dividing cells. Stains were positive for cytokeratin and vimentin and negative for CEA, EMA, Leu-M1 and factor VIII-related antigen, findings the authors took as supporting mesothelioma. No tumor was found elsewhere, and he was well without recurrence or metastasis 5 months after surgery. The authors found 15 earlier cases in the English literature. Across these and the present case, excluding one earlier case whose course was not described, recurrence or metastasis occurred in 8 cases (53%), and 6 of those patients died. The authors concluded that this tumor apparently carries a grave 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 with a review of previously published cases
• Who was studied: one 32-year-old Japanese man with a tumor in the right scrotum, seen at Nagoya City University Medical School, Japan; plus 15 earlier cases from the English literature reviewed
• Exposure: the patient had no history of asbestos exposure
• Main results:
  • The right testis was removed through the groin (right inguinal orchiectomy).
  • In this patient, a 1 x 1 x 1 cm solid tumor was found in the tunica vaginalis at the lower surface of the right testis.
  • Under the microscope, the patient's tumor had glandular and papillary structures and invaded the tunica albuginea.
  • Numerous mitoses (dividing cells) were found in the patient's tumor.
  • In the patient's tumor, many cells stained positive for cytokeratin and most for vimentin.
  • The patient's tumor cells were negative for CEA, EMA, Leu-M1 and factor VIII-related antigen. The authors said this staining pattern supported the diagnosis of mesothelioma.
  • Examination after surgery found no tumor elsewhere in the patient's body.
  • The patient was well, without recurrence or metastasis, 5 months after the operation.
  • The authors found 15 previously reported cases of malignant mesothelioma in this location in the English literature.
  • Among the reviewed cases plus the present one, the first symptom was hydrocele or hematocele in 8 cases (50%). This was not so for the present case.
  • Excluding one earlier case with no description of the clinical course, recurrence or metastasis occurred in 8 cases (53%), and 6 of these patients died.
• The authors' conclusion: The authors diagnosed the tumor as malignant mesothelioma of the tunica vaginalis. They concluded that this tumor apparently carries a grave prognosis and that more intensive therapies should be considered.

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, Asbestos Exposure, Carcinoembryonic Antigen (CEA), Epithelial Membrane Antigen (EMA), Differential Diagnosis.

Related studies

• Mesothelioma of tunica vaginalis testis and asbestos exposure — C. Mensi, M. Pellegatta, et al. (2012)
• Torsed appendix epididymis in an adult: misdiagnosis as tumor of tunica vaginalis on sonography — D.M. Yang, H.C. Kim, et al. (2018)
• Malignant mesothelioma of tunica vaginalis testis — G. Tyagi, C.S. Munn, et al. (1989)
• Mesothelioma of the tunica vaginalis testis: report of 2 cases with asbestos occupational exposure — G. Gorini, M. Pinelli, et al. (2005)
• Immunohistochemical profile of paratesticular serous papillary adenocarcinoma and tunica vaginalis facilitates distinction from malignant mesothelioma — P.R. Anchala, R. Dhir, et al. (2011)
• Malignant Mesothelioma of the Tunica Vaginalis Testis-A Malignancy Associated With Asbestos Exposure and Trauma: A Case Report and Literature Review — A.A. Baqui, N.A. Boire, et al. (2019)

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