Malignant mesothelioma of tunica vaginalis testis

Our plain-English summary of Malignant mesothelioma of tunica vaginalis testis, by G. Tyagi, C.S. Munn, L.C. Kiser, et al (Urology, 1989).

The study

• Authors: G. Tyagi, C.S. Munn, L.C. Kiser, S.M. Wetzner, E. Tarabulcy
• Journal: Urology
• Published: 1989;34(2):102-4
• Type of article: Case report
• Cited by: 33 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. 000172).

Abstract

Malignant mesothelioma of the tunica vaginalis is rare, but sometimes curable. It is similar to malignant mesothelioma of the peritoneum and of the pleura, and is likewise associated with asbestos exposure. We report a case, with correlative computed tomography, ultrasound, and gross pathology images that demonstrate tiny tumor implants studding the vaginalis testis. The literature is reviewed.

In plain English

This is a case report with a brief review of earlier published cases. The authors described a 79-year-old man with persistent right facial neuralgia (nerve pain) who was admitted to a Boston hospital for trigeminal neurotomy, an operation on the trigeminal nerve. He had a painless, fluid-filled swelling of the left scrotum that had been present for about six months. Chest X-rays showed pleural plaques on both sides, and he had worked in a shipyard installing asbestos. Ultrasound and CT showed fluid with many small nodules (about 2-10 mm on ultrasound) studding the lining of the scrotal sac. CT showed no sign of spread in the pelvis or abdomen. After surgery to remove the left testis, the nodules proved to be malignant mesothelioma of the tunica vaginalis, plus one nodule of the testis. From the literature, the authors noted that asbestos exposure was documented in only 6 of 26 earlier cases, and that mean survival was 28 months among 10 reported deaths. The authors concluded that the diagnosis should be suspected when someone with signs of asbestos exposure has a hydrocele and/or a mass over 2 cm.

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 one patient, with a brief review of previously published cases
• Who was studied: One 79-year-old man with persistent right facial neuralgia, admitted to New England Baptist Hospital, Boston, Massachusetts, for trigeminal neurotomy, who was found to have an enlarged left scrotum
• Exposure: Occupational asbestos exposure as a shipyard worker involved in asbestos installation; fiber type not stated
• Main results:
  • The patient's chest films showed bilateral pleural plaques
  • Ultrasound showed an apparent hydrocele with multiple small masses, about 2-10 mm, studding the scrotal sac lining
  • CT showed small soft tissue masses (about 4-10 mm) on the scrotal sac lining and no lymph node enlargement or peritoneal implants in the pelvis or abdomen
  • At left radical inguinal orchiectomy, pathology found multiple nodular lesions 0.1 to 1.2 cm in diameter on the scrotal sac lining, which histology showed to be malignant mesothelioma of the tunica vaginalis, with one nodule of the testis
  • In the literature reviewed by the authors, asbestos exposure had been documented in only 6 of 26 previously reported cases
  • Among previously reported cases in which deaths from this disease were reported (10 cases), mean survival was 28 months after diagnosis
• The authors' conclusion: The authors concluded that the diagnosis should be suspected in any patient whose history or chest X-ray suggests asbestos exposure and who has a hydrocele and/or a mass greater than 2 cm. They also noted the striking studding of the tunica with tumor nodules seen in this case.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Tunica Vaginalis, Peritoneum, Pleura, Asbestos Exposure, Ultrasound, Pathology.

Related studies

• Cutaneous manifestations of malignant mesothelioma of the tunica vaginalis testis — H.J. van der Rhee, W.A. van Vloten, et al. (1983)
• Fine needle aspiration cytology in malignant mesothelioma of the tunica vaginalis testis — R. Gupta, P. Dey, et al. (2011)
• Mesothelioma of tunica vaginalis testis and asbestos exposure — C. Mensi, M. Pellegatta, et al. (2012)
• Malignant mesothelioma of the tunica vaginalis testis: unusual sonographic appearance — M.T. Wang, C.W. Mak, et al. (2005)
• 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 the tunica vaginalis: a atypical presentation of a rare scrotal tumour — M.C. Harris, C. Logan, et al. (2019)

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