Malignant mesothelioma of the tunica vaginalis: a atypical presentation of a rare scrotal tumour

Our plain-English summary of Malignant mesothelioma of the tunica vaginalis: a atypical presentation of a rare scrotal tumour, by M.C. Harris, C. Logan, A. Chetwood, et al (ANZ Journal of Surgery, 2019).

The study

• Authors: M.C. Harris, C. Logan, A. Chetwood, P. Cohen, J. Titus, T.H. Tan, B. Higgs, N.R. Brook
• Journal: ANZ Journal of Surgery
• Published: 2019;89(12):E562-E563
• Type of article: Case report
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This is a case report from the Royal Adelaide Hospital, South Australia, about one 41-year-old man with malignant mesothelioma of the tunica vaginalis, the lining around the testis. He saw his general practitioner about a painless, enlarged lymph node in his right groin, with no scrotal swelling or testicular pain. He denied previous asbestos exposure. Thirteen years earlier he had a right scrotal fluid swelling (hydrocele) that went away on its own. The lymph node showed malignant mesothelioma. Scans found a right scrotal mass and enlarged right external iliac (70 mm) and inguinal (35 mm) lymph nodes. After his right testis was removed, the entire tunica vaginalis was found to be replaced by tumour, reported as biphasic mesothelioma. He then had lymph node surgery, radiation therapy and four cycles of chemotherapy. A scan 12 months after the lymph node surgery showed no recurrence or spread. He had ongoing right leg swelling (lymphoedema). The authors believed this was the first reported case diagnosed from lymph node spread alone in a patient with a past, but not current, hydrocele.

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 (single patient)
• Who was studied: One 41-year-old man treated at the Royal Adelaide Hospital, Adelaide, South Australia (report published 2019)
• Exposure: No asbestos exposure reported: the patient denied previous asbestos exposure
• Main results:
  • The patient had a right scrotal swelling (a large right hydrocele) 13 years earlier, which resolved on its own
  • Imaging of the patient showed a multifocal right scrotal mass with tunica involvement and enlarged right external iliac and inguinal lymph nodes measuring 70 mm and 35 mm
  • A scrotal mass could not be felt on examination, and testicular tumour markers were normal
  • The patient underwent urgent removal of the right testis (right inguinal orchidectomy)
  • In the removed specimen the entire tunica vaginalis was replaced by tumour, and the tumour was reported as a biphasic mesothelioma
  • After lymph node dissection, the two enlarged lymph nodes confirmed malignant mesothelioma of the tunica vaginalis, and the other removed nodes were free of disease
  • The patient received intensity-modulated radiation therapy of the pelvis and hemiscrotum, and four cycles of chemotherapy
  • A CT scan 12 months after the lymph node surgery showed no local recurrence and no nodal or metastatic disease
  • The patient had ongoing right lower limb lymphoedema
• The authors' conclusion: The authors believed this to be the first reported case of malignant mesothelioma of the tunica vaginalis diagnosed from lymphatic spread alone in a patient with a previous, but not current, hydrocele

Topics

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

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

Related studies

• Mesothelioma of the tunica vaginalis testis: a rare malignancy mimicking more common inguino-scrotal masses — P.J. Schure, K.C. van Dalen, et al. (2006)
• Cutaneous manifestations of malignant mesothelioma of the tunica vaginalis testis — H.J. van der Rhee, W.A. van Vloten, et al. (1983)
• Fine needle aspiration cytology in malignant mesothelioma of the tunica vaginalis testis — R. Gupta, P. Dey, et al. (2011)
• Malignant mesothelioma of the tunica vaginalis testis: a rare case and review of literature — M. Drevinskaite, A. Patasius, et al. (2020)
• Extremely rare tumour--malignant mesothelioma of tunica vaginalis testis — T. Jankovichova, M. Jankovich, et al. (2015)
• Malignant mesothelioma of tunica vaginalis testis — G. Tyagi, C.S. Munn, et al. (1989)

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