Malignant Mesothelioma of the Tunica Vaginalis: A Rare Neoplasm--Case Report and Literature Review

Our plain-English summary of Malignant Mesothelioma of the Tunica Vaginalis: A Rare Neoplasm--Case Report and Literature Review, by M. Segura-González, J. Urias-Rocha, J. Castelán-Pedraza (Clinical Genitourinary Cancer, 2015).

The study

• Authors: M. Segura-González, J. Urias-Rocha, J. Castelán-Pedraza
• Journal: Clinical Genitourinary Cancer
• Published: 2015;13(6):e401-5
• Type of article: Case report, Review
• Cited by: 12 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

The authors reported a case of malignant mesothelioma of the tunica vaginalis, a rare tumour of the lining around the testis, and reviewed the literature. They noted that about 223 cases had been reported and that only 34.2% of patients had a history of asbestos exposure. The patient was a 58-year-old man who denied asbestos exposure and smoking. He had scrotal pain and swelling that had increased over 8 months and had not responded to outpatient treatment for orchiepididymitis. Left leg swelling had begun 3 months before his first assessment. Ultrasound showed hydrocele and microlithiasis, and Doppler ultrasound confirmed left iliofemoral deep venous thrombosis. After left radical orchiectomy, pathology showed an epithelioid malignant tumour of the tunica vaginalis invading the epididymis. Immunohistochemistry was positive for cytokeratin 5/6, cytokeratin 7 and calretinin, and negative for WT1. CT showed a tumour mass in the left vesicorectal space. He received 6 cycles of gemcitabine and carboplatin, then pelvic radiotherapy of 50 Gy in 25 fractions. The disease was stable, with 23% tumour shrinkage, and progression-free survival was 6 months at last follow-up. The authors concluded that surgery remains the main treatment and that chemotherapy and radiotherapy could be offered to some patients with gross residual disease after surgery. They stated that this was, to their knowledge, the first such case reported in a Latin American patient.

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 article reported one patient with malignant mesothelioma of the tunica vaginalis, the membrane around the testis, and reviewed earlier reports. The patient was a 58-year-old man who denied asbestos exposure and smoking. He had scrotal pain and swelling that had increased over 8 months. He was first treated for several days for orchiepididymitis (inflammation of the testis and epididymis), without response. He later developed a deep vein blood clot in the left leg. Ultrasound showed fluid around the testis. The left testis was removed, and tissue examination showed the cancer. A scan then found a tumor mass in the pelvis. He received six cycles of gemcitabine-carboplatin chemotherapy, then pelvic radiotherapy. Treatment left the disease stable, with 23% tumor shrinkage. No progression was seen after 6 months. The authors concluded that surgery remains the main treatment and that chemotherapy and radiotherapy could be offered in some cases with visible tumor remaining after surgery. They noted this combined approach's benefit has not been established. To their knowledge, this was the first such case reported in a Latin American patient.

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 of a single patient, with a literature review
• Who was studied: One 58-year-old man referred to the authors' hospital (the authors' affiliations are in Mexico City, Mexico); dates of care not given
• Exposure: No asbestos exposure reported: the patient denied asbestos exposure and smoking
• Main results:
  • Before diagnosis, the patient was treated as an outpatient for orchiepididymitis (inflammation of the testis and epididymis) for several days without response
  • He developed progressive swelling of the left leg, and Doppler ultrasound confirmed a left ileofemoral deep venous thrombosis
  • Testicular ultrasound showed hydrocele and microlithiasis
  • A left radical orchiectomy (surgical removal of the left testis) was performed
  • Pathology showed an epithelioid malignant neoplasm of the tunica vaginalis that invaded the epididymis but not the testicular tissue or spermatic cord
  • Immunohistochemistry was positive for cytokeratin 5/6, cytokeratin 7 and calretinin, and WT1 was negative
  • A CT scan after surgery showed a tumor mass in the left vesicorectal space and thickening of the upper and middle rectum wall
  • The patient received platinum-based chemotherapy (gemcitabine plus carboplatin) for 6 cycles. Carboplatin was used because of obstructive uropathy, and gemcitabine was used instead of pemetrexed because it was cheaper
  • Pelvic radiotherapy was then given at 50 Gy in 25 fractions
  • At the end of treatment the disease was stable, with 23% tumor shrinkage by RECIST 1.1
  • There was no evidence of progression at last follow-up, with a progression-free survival of 6 months to date
  • The literature review included a table summarizing earlier case reports and case series of mesothelioma of the tunica vaginalis
• The authors' conclusion: The authors concluded that surgery remains the main treatment, that chemotherapy and radiotherapy could be offered in some cases of gross (visible) residual disease after surgery, and that, to their knowledge, this was the first case of this disease reported in a Latin American patient
• Limitations the authors state:
  • The authors noted that the true efficacy of multimodal treatment (surgery, chemotherapy and radiotherapy) for this disease has not yet been established

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, Neoplasm, Asbestos Exposure, Ultrasound, Hydrocele, Doppler Ultrasound, Orchiectomy.

Related studies

• Malignant mesothelioma of the tunica vaginalis testis: a rare case and review of literature — M. Drevinskaite, A. Patasius, et al. (2020)
• Malignant mesothelioma of tunica vaginalis testis: Report of a very rare case with review of the literature — E. Trenti, S.M. Palermo, et al. (2018)
• 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)
• Rare tumors of the testis and mesothelial proliferation in the tunica vaginalis — M. Colecchia, G. Mikuz, et al. (2012)
• Extremely rare tumour--malignant mesothelioma of tunica vaginalis testis — T. Jankovichova, M. Jankovich, et al. (2015)
• Cutaneous recurrence of malignant mesothelioma of the tunica vaginalis testis: a rare case report — P. Priester, J. Kopecký, et al. (2012)

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