Malignant mesothelioma of the tunica vaginalis testis: unusual sonographic appearance

Our plain-English summary of Malignant mesothelioma of the tunica vaginalis testis: unusual sonographic appearance, by M.T. Wang, C.W. Mak, W.S. Tzeng, et al (Journal of Clinical Ultrasound, 2005).

The study

• Authors: M.T. Wang, C.W. Mak, W.S. Tzeng, J.C. Chen, J.M. Chang, C.N. Lin
• Journal: Journal of Clinical Ultrasound
• Published: 2005;33(8):418-20
• Type of article: Case report
• Cited by: 8 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Malignant mesothelioma of the tunica vaginalis testis is a rare and aggressive neoplasm. It is similar to malignant mesothelioma of the peritoneum, usually associated with asbestos exposure. We present an unusual case in which the tumor was a mix of a hypoechoic solid nodule and a cystic component with low-level internal echoes.

Copyright 2005 Wiley Periodicals, Inc.

In plain English

This case report from Taiwan described one patient with malignant mesothelioma of the tunica vaginalis, the membrane around the testis. An 81-year-old man had a right scrotal mass that had been enlarging for 3 years. He denied past exposure to asbestos. Ultrasound showed a mass near the right epididymal head with two side-by-side parts: a solid medial portion (toward the body's midline) and a cystic (fluid-filled) lateral portion with faint internal echoes. Color Doppler ultrasound showed only minimal blood flow in the mass. The tumor was surgically removed, and microscope and tissue-staining tests confirmed mesothelioma arising from the tunica vaginalis. The testis and epididymis were not affected, and staging scans showed no evidence of spread. The authors said the large cystic part, which mimicked an epididymal cystic lesion, made this case differ from earlier reports. The authors concluded that mesothelioma should be considered for a mass beside the testis in middle-aged or older patients, even without asbestos exposure. A single-patient report cannot show how common this tumor is or how often it is linked to asbestos.

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 81-year-old man with a right scrotal mass; the authors were at hospitals in Taiwan; the date of presentation is not given
• Exposure: no asbestos exposure reported; the patient denied past exposure to asbestos
• Main results:
  • In this patient, the right scrotal mass had been progressively enlarging for 3 years
  • On ultrasound, the patient's tumor had two components side by side: a solid, hypoechoic medial portion and a cystic lateral portion with low-level internal echoes
  • Color Doppler ultrasound showed only minimal vascularity within the patient's mass
  • After resection, immunohistochemistry of the patient's tumor was positive for cytokeratin, epithelial membrane antigen and calretinin and negative for carcinoembryonic antigen, confirming mesothelioma arising from the tunica vaginalis
  • In this patient, the testis and epididymis were not affected, and staging chest radiograph and CT of the abdomen and pelvis showed no evidence of metastasis
  • The authors reported that this case differed from previous reports because the tumor had a large cystic component that mimicked an epididymal cystic lesion
• The authors' conclusion: The authors concluded that mesothelioma should be included in the differential diagnosis of a paratesticular mass in middle-aged or older patients, even in the absence of asbestos exposure

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, Peritoneum, Asbestos Exposure.

Related studies

• Well-differentiated papillary mesothelioma of tunica vaginalis testis of unknown malignant potential: Sonographic appearance — K.W.S. Ko, K.S. Tse, et al. (2018)
• Malignant mesothelioma of tunica vaginalis testis — G. Tyagi, C.S. Munn, et al. (1989)
• The sonographic appearance of an intratesticular adenomatoid tumor — W.J. Somers (1992)
• Imaging of mesothelioma of tunica vaginalis testis — M. Bertolotto, I. Boulay-Coletta, et al. (2016)
• Mesothelioma of the tunica vaginalis testis — K.J. Butnor, E.N. Pavlisko, et al. (2019)
• Mesothelioma of tunica vaginalis testis and asbestos exposure — C. Mensi, M. Pellegatta, et al. (2012)

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