Malignant mesothelioma of the tunica vaginalis testis: a case report

Our plain-English summary of Malignant mesothelioma of the tunica vaginalis testis: a case report, by S. Prescott, R.E. Taylor, G. Sclare, et al (The Journal of Urology, 1988).

The study

• Authors: S. Prescott, R.E. Taylor, G. Sclare, A. Busuttil
• Journal: The Journal of Urology
• Published: 1988;140(3):623-4
• Type of article: Case report
• Cited by: 25 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. 000930).

Abstract

We report a case of malignant mesothelioma of the testicular tunica vaginalis. A preceding hydrocele showed mesothelial hyperplasia of its lining. The tumor was treated surgically as well as with a combination of radiotherapy and chemotherapy but it progressed, resulting in death within 21 months from the diagnosis. The relationship of the tumor to mesothelial hyperplasia and to previous exposure to asbestos is discussed.

In plain English

This case report described one man in Scotland with malignant mesothelioma of the tunica vaginalis, the lining around the testis. He was a 61-year-old retired salesman with no history of asbestos exposure. In 1983 an enlarging left hydrocele (fluid around the testis) was removed, and its lining showed focal overgrowth of lining cells. In 1985 he returned with a hard scrotal mass, which proved to be malignant mesothelioma. On review, the earlier hydrocele lining was regarded in retrospect as atypical and the precursor of the tumor. After surgery and radiotherapy, the tumor recurred locally eight months after surgery. It then progressed despite chemotherapy. He died 21 months after diagnosis. At autopsy there were pleural plaques, which the authors considered indicative of prior asbestos exposure. No asbestos fibers were seen on ordinary microscopy of lung sections. After lung tissue was chemically dissolved, asbestos fibers were found in low concentration; the fiber type was not stated. The authors concluded that mesothelial hyperplasia of the tunica vaginalis, until then treated as benign, is not always so, and should prompt careful follow-up.

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, including biopsy and autopsy findings)
• Who was studied: One 61-year-old retired salesman treated at hospitals in West Lothian and Edinburgh, Scotland. He first presented in November 1982 and died in December 1986.
• Exposure: No history of asbestos exposure was recorded. At autopsy, pleural plaques consistent with prior asbestos exposure were found, and asbestos fibers were found in low concentration in dissolved lung tissue. The fiber type was not stated.
• Main results:
  • The hydrocele sac removed in March 1983 showed focal serosal hyperplasia.
  • The scrotal mass removed by inguinal orchiectomy in 1985 showed two closely intermingled patterns characteristic of malignant mesothelioma.
  • On review, the cells in the earlier hydrocele sac were regarded in retrospect as atypical, representing the precursor of the mesothelioma.
  • Local recurrence, confirmed by tissue examination, was noted eight months after orchiectomy. This followed radiotherapy to the iliac and inguinal nodes and scrotum.
  • After the recurrence, the tumor progressed despite chemotherapy with etoposide, followed by 5-fluorouracil and mitozantrone.
  • The patient died 21 months after diagnosis, in December 1986.
  • At autopsy, metastatic tumor was found in the iliac, para-aortic, mediastinal and cervical lymph nodes and in the lung tissue.
  • No asbestos fibers were seen on microscopy of several lung sections.
  • After a lung tissue specimen was dissolved in sodium hypochlorite solution, asbestos fibers were found in low concentration.
  • The authors regarded the pleural plaques as indicative of prior asbestos exposure, which they said was confirmed by the asbestos fibers found in the lung.
• The authors' conclusion: The authors concluded that mesothelial hyperplasia of the tunica vaginalis, until then treated as a benign condition, is not always benign. In their view, nodular mesothelial proliferation in an excised hydrocele sac, or hyperplastic mesothelial cells in hydrocele fluid, should be interpreted as incipient mesothelioma and followed carefully.

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, Hydrocele, Reactive Mesothelial Hyperplasia, Chemotherapy.

Related studies

• Malignant mesothelioma of the tunica vaginalis testis: report of first case with preoperative diagnosis — L. Japko, A.A. Horta, et al. (1982)
• Malignant mesothelioma of the tunica vaginalis testis — K. Antman, S. Cohen, et al. (1984)
• Epidemiology of mesothelioma of the pericardium and tunica vaginalis testis — G. Mezei, E.T. Chang, et al. (2017)
• Malignant mesothelioma of the tunica vaginalis testis: diagnostic studies and differential diagnosis — S.S. Chekol, C.C. Sun (2012)
• 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 — G. Tyagi, C.S. Munn, et al. (1989)

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