Malignant Mesothelioma of Tunica Vaginalis Testis: Macroscopic and Microscopic Features of a Very Rare Malignancy

Our plain-English summary of Malignant Mesothelioma of Tunica Vaginalis Testis: Macroscopic and Microscopic Features of a Very Rare Malignancy, by E. Arda, M.G. Arıkan, G. Cetin, et al (Curēus, 2017).

The study

• Authors: E. Arda, M.G. Arıkan, G. Cetin, U. Kuyumcuoğlu, U. Usta
• Journal: Curēus
• Published: 2017;9(11):e1860
• Type of article: Case report
• Cited by: 8 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Malignant mesothelioma of the tunica vaginalis testis (MMTVT) is an extremely rare tumour, usually mimicking benign pathologies of the scrotum. Our case is an 84-year-old male patient who appealed with a painless, left-sided scrotal swelling longer than 2 months. Although the level of tumour markers was normal, ultrasonographic examination results forced us to perform an inguinal scrotal exploration. Multiple small papillary tumours, both on tunica vaginalis and tunica albuginea, were detected intraoperatively. Due to these findings, radical orchiectomy was performed. A pathological evaluation showed malignant mesothelioma (MM) of the tunica vaginalis testis. Exposure to asbestos is a well-known risk factor. Furthermore, a history of trauma, herniorrhaphy and chronic hydroceles is blamed as a possible risk factor. Scrotal ultrasonography is the mainstay of primary diagnosis and, therefore, it should not be overlooked when dealing with benign scrotal cysts or hydroceles, which are very common pathologies at these decades, too. Radical inguinal orchiectomy is the primary treatment choice for localised MMTVT disease, whereas in signs of lymph node metastasis, inguinal lymph node dissection is required. Radical resection should be completed with chemotherapy and/or radiotherapy for an advanced or recurrent disease. This case, which is very rarely reported in the literature and detected during inguinal exploration, along with the pathological works that supported the diagnosis, was presented with this report.

In plain English

This is a case report about one patient, written by doctors at Trakya University. An 84-year-old man came in with a painless swelling on the left side of his scrotum that had lasted more than 2 months. He reported no previous surgery or injury to the area. Ultrasound showed thickening and multiple solid papillary (finger-like) growths on the tunica vaginalis, the membrane that surrounds the testis. Blood tumour markers were normal. CT scans of the pelvis, abdomen and chest showed no sign of spread. During an operation through the groin, the surgeons found multiple small papillary tumours on the tunica vaginalis and on the tunica albuginea, and removed the testis (a radical orchiectomy). Tissue examination diagnosed malignant mesothelioma of the tunica vaginalis testis. The authors stated that they did not identify any risk factor in this case. The patient received no chemotherapy or radiotherapy. The authors reported no sign of spread or recurrence but did not say how long he was followed. The authors concluded that this cancer should not be overlooked when assessing scrotal cysts or hydroceles, which are very common at the same ages.

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)
• Who was studied: one 84-year-old man with a painless left-sided scrotal swelling lasting more than 2 months, treated by the authors at Trakya University (Turkey); date of treatment not stated
• Exposure: No asbestos exposure or other risk factor was identified in this patient. The article does not describe any fiber type, job or product.
• Main results:
  • Ultrasound showed irregular thickening and multiple well-vascularized papillary solid lesions of the tunica vaginalis.
  • CT of the pelvis, abdomen and thorax showed no sign of metastasis.
  • Based on what was seen during surgery (multiple small papillary tumours on the tunica vaginalis and tunica albuginea), a radical orchiectomy was performed.
  • The removed tissue showed multiple papillary nodules on the tunica vaginalis with an average size of 0.5-1 cm.
  • The pathological evaluation diagnosed malignant mesothelioma of the tunica vaginalis testis.
  • The patient received no chemotherapy or radiotherapy and showed no sign of metastasis or recurrence. The follow-up period is not stated.
• The authors' conclusion: The authors concluded that malignant mesothelioma of the tunica vaginalis testis should not be overlooked when dealing with benign scrotal cysts or hydroceles, which are very common at the same ages.

Topics

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Tunica Vaginalis, Orchiectomy, Hydrocele, Radical Inguinal Orchiectomy, Metastasis, Chemotherapy.

Related studies

• 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)
• Malignant Mesothelioma of the Tunica Vaginalis Testis-A Malignancy Associated With Asbestos Exposure and Trauma: A Case Report and Literature Review — A.A. Baqui, N.A. Boire, et al. (2019)
• Malignant mesothelioma of the tunica vaginalis testis: a rare case and review of literature — M. Drevinskaite, A. Patasius, et al. (2020)
• 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)

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