Malignant Mesothelioma of the Tunica Vaginalis Testis-A Malignancy Associated With Asbestos Exposure and Trauma: A Case Report and Literature Review

Our plain-English summary of Malignant Mesothelioma of the Tunica Vaginalis Testis-A Malignancy Associated With Asbestos Exposure and Trauma: A Case Report and Literature Review, by A.A. Baqui, N.A. Boire, T.T. Baqui, et al (Journal of Investigative Medicine High Impact Case Reports, 2019).

The study

• Authors: A.A. Baqui, N.A. Boire, T.T. Baqui, D.J. Etwaru
• Journal: Journal of Investigative Medicine High Impact Case Reports
• Published: 2019;7:2324709619827335
• Type of article: Case report, Review
• Cited by: 8 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

In this article, we report an unusual case of a malignant mesothelioma of the testis, presenting as hydrocele. The patient has a known medical history of trauma and occupational exposure to asbestos. The clinical features of this injury are discussed together with its immunohistochemistry. Surgical intervention is discussed due to the nature of this pathology.

In plain English

This case report described one man with malignant mesothelioma of the tunica vaginalis, the lining around the testis. He was 63, of African origin (Kenya), and had worked with boilers. The authors described this as occupational asbestos exposure, but the article did not name a fiber type or give exposure details. He also had a history of trauma: a brain aneurysm that developed after a motorcycle accident. He had a large left testicular hydrocele (fluid swelling, 8 × 3 cm) that had been growing for over a year. Ultrasound showed a complex hydrocele. At surgery, 1300 cc of straw-colored fluid was found, and the sac and left testicular tissue were removed. Pathology confirmed epithelioid malignant mesothelioma. A follow-up scan showed no hypermetabolic areas except a small 9 mm thyroid nodule. More radical surgery and then chemotherapy were planned, but no outcome was reported. The authors concluded that this cancer should be considered in men with scrotal masses, whether or not they have a history of asbestos exposure, and that aggressive surgery should be the first treatment.

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) with brief discussion of published literature
• Who was studied: one 63-year-old man of African origin (Kenya) with a large left testicular hydrocele
• Exposure: occupational work exposure to boilers, described by the authors as occupational asbestos exposure (no fiber type stated); also a history of trauma (motorcycle accident)
• Main results:
  • The patient had a large left testicular hydrocele measuring 8 × 3 cm that had been developing for over 1 year
  • Ultrasound showed a complex left hydrocele with a 1.7 cm solid structure possibly representing the left testis
  • At surgery, 1300 cc of straw-colored fluid was found, and the hydrocele sac and left testicular tissue were removed by scrotal orchiectomy
  • Pathology confirmed malignant mesothelioma, epithelioid type
  • Tumor cells were positive for WT-1 and calretinin, and focally for D2-40; BAP-1 was retained
  • Follow-up PET/CT showed no hypermetabolic foci except a small 9 mm hypodense nodule in the right lobe of the thyroid
  • Radical excision was planned, with chemotherapy to follow the more extensive surgery; no outcome was reported
• The authors' conclusion: The authors concluded that malignant mesothelioma should be part of the differential diagnosis in patients with scrotal masses, whether or not they have a history of asbestos exposure, and that aggressive surgical management should be the first line of treatment once the diagnosis is established

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: Malignant Mesothelioma, Tunica Vaginalis, Asbestos Exposure, Hydrocele, Occupational Exposure, Immunohistochemistry, Pathology.

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)
• 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: report of 2 cases with asbestos occupational exposure — G. Gorini, M. Pinelli, et al. (2005)
• 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 — K.J. Butnor, E.N. Pavlisko, et al. (2019)
• Biphasic malignant mesothelioma of the tunica vaginalis testis — K.C. Saw, T.H. Barker, et al. (1994)

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