Malignant mesothelioma of the tunica vaginalis: a case with an unusually indolent course following radical orchidectomy and radiotherapy

Our plain-English summary of Malignant mesothelioma of the tunica vaginalis: a case with an unusually indolent course following radical orchidectomy and radiotherapy, by J.L. Harmse, A.T. Evans, P.M. Windsor (The British Journal of Radiology, 1999).

The study

• Authors: J.L. Harmse, A.T. Evans, P.M. Windsor
• Journal: The British Journal of Radiology
• Published: 1999;72(857):502-4
• Type of article: Case report
• Cited by: 11 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Malignant mesothelioma (malignant adenomatoid tumour) of the tunica vaginalis testis is a very rare neoplasm with highly aggressive biological behaviour. Treatment is difficult, and widespread local invasion and/or metastatic disease at presentation are associated with a poor prognosis. In this case report we describe for the first time a patient who, despite presenting with locally advanced disease, remains well 10 years after diagnosis and treatment with radical orchidectomy and high dose radiotherapy.

In plain English

This was a case report of one man with malignant mesothelioma of the tunica vaginalis, the membrane around the testis. He was 70 when he presented in November 1988 with a right scrotal mass; a right hydrocele had been repaired 18 years earlier. He had no history of asbestos exposure; the authors noted the earlier surgery might be thought to represent a traumatic insult. His right testis was removed (radical orchidectomy). The tumour arose from the tunica vaginalis and had invaded the testis and the overlying muscle and skin. The diagnosis was confirmed as primary malignant mesothelioma. A CT scan showed no sign of spread to the lungs or to paraaortic or pelvic lymph nodes. He then received radiotherapy to the whole scrotum and right groin, a maximum dose of 45 Gy in 20 fractions over 28 days. After 10 years of follow-up he remained alive and well with no evidence of recurrence. The authors believed this was the first reported case with 10-year disease-free survival despite locally advanced disease at presentation. A case report shows one patient's course, not a rate.

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 70-year-old man who presented in November 1988 with a right scrotal mass. A right hydrocele had been repaired 18 years earlier.
• Exposure: The patient had no history of asbestos exposure. The authors noted that his earlier surgery to correct a right hydrocele might be thought to represent a traumatic insult.
• Main results:
  • The tumour arose from the tunica vaginalis and invaded the testicular tissue and the overlying muscle and skin.
  • Tests in 1988 and an expert opinion supported a diagnosis of malignant mesothelioma. A later review with current markers confirmed primary malignant mesothelioma arising in the tunica vaginalis.
  • A staging CT scan of the thorax, abdomen and pelvis showed no evidence of lung metastases or of spread to paraaortic or pelvic lymph nodes.
  • After radical orchidectomy he received radiotherapy to the whole scrotum and right groin, with a maximum dose of 45 Gy in 20 fractions over 28 days. He developed skin reactions and later telangiectasia of the scrotum and perineum, which caused him no symptoms.
  • After 10 years of follow-up the patient remained alive and well with no evidence of recurrent locoregional or metastatic disease.
• The authors' conclusion: The authors stated that, to the best of their knowledge, this was the first case reported in the literature with 10-year disease-free survival despite locally advanced disease at presentation.

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, Tunica Vaginalis, Adenomatoid Tumor, Neoplasm, Prognosis.

Related studies

• Malignant Mesothelioma of the Tunica Vaginalis Testis: Outcomes Following Surgical Management Beyond Radical Orchiectomy — P. Recabal, B. Rosenzweig, et al. (2017)
• Malignant mesothelioma of the tunica vaginalis testis: diagnostic studies and differential diagnosis — S.S. Chekol, C.C. Sun (2012)
• Mesothelioma of the tunica vaginalis: a series of eight cases with uncertain malignant potential — F. Brimo, P.B. Illei, et al. (2010)
• Malignant mesothelioma of the tunica vaginalis testis: a rare case and review of literature — M. Drevinskaite, A. Patasius, et al. (2020)
• Mesothelioma of the tunica vaginalis testis — K.J. Butnor, E.N. Pavlisko, et al. (2019)
• Malignant mesothelioma of testicular tunica vaginalis — K. Abe, N. Kato, et al. (2002)

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