Malignant papillary mesothelioma of the tunica vaginalis testes: cutaneous metastases showing pagetoid epidermal invasion

Our plain-English summary of Malignant papillary mesothelioma of the tunica vaginalis testes: cutaneous metastases showing pagetoid epidermal invasion, by L.E. Cartwright, H.K. Steinman (Journal of the American Academy of Dermatology, 1987).

The study

• Authors: L.E. Cartwright, H.K. Steinman
• Journal: Journal of the American Academy of Dermatology
• Published: 1987;17(5 Pt 2):887-90
• Type of article: Case report
• Cited by: 22 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Malignant papillary mesothelioma of the tunica vaginalis testis is an extremely rare tumor arising from the mesothelium of the tunica vaginalis. A total of 14 cases have been reported, with only two exhibiting cutaneous metastases. We present a third case of cutaneous metastases arising from this unusual tumor. In addition, this is the first reported case of the occurrence of pagetoid epidermal invasion in this condition.

In plain English

This was a case report of malignant papillary mesothelioma of the tunica vaginalis testis, a tumor of the lining around the testis. The authors described a 49-year-old white man who had surgery for a right hydrocele in July 1982. Biopsies at that time showed no tumor. A right testis mass was noted in November 1983. The tumor was diagnosed in September 1984, when the right testis and half the scrotum were removed. It had spread to 5 of 10 inguinal lymph nodes sampled and to the lungs. On admission for chemotherapy in January 1985, firm, waxy bumps were noted on the penis and scrotum, plus a tender plaque on the underside of the penis; tests found these consistent with spread of the mesothelioma. Unexpectedly, atypical cells also spread through the outer skin layer in a "pagetoid" pattern. Multiple courses of chemotherapy did not stop tumor growth. The authors called this the third reported case with skin spread and the first with pagetoid invasion. They concluded this tumor should be considered when such skin changes are seen. The article does not mention 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 49-year-old white man; authors were at the Veterans Administration Medical Center, San Diego, and University of California, San Diego; events from 1982 to 1985
• Main results:
  • Biopsies of the testis and tunica vaginalis at the 1982 hydrocele surgery showed no tumor
  • Diagnosis of malignant papillary mesothelioma of the tunica vaginalis propria testis was made in September 1984 at removal of the right testis and half the scrotum
  • Spread to 5 of 10 inguinal lymph nodes sampled
  • Multiple lung nodules proved on biopsy to be metastatic mesothelioma
  • On admission for chemotherapy in January 1985, several 1-3 mm firm, waxy papules were noted on the penis and scrotum, plus a tender 1 x 2 cm plaque on the ventral (under) side of the penis
  • Microscope and electron microscope examination of the skin lesions was consistent with malignant papillary mesothelioma
  • Atypical cells spread upward through the epidermis in a pagetoid pattern, which the authors called an unexpected finding
  • Multiple courses of chemotherapy did not halt tumor growth
  • The authors stated this was the third reported case of this tumor with skin invasion
• The authors' conclusion: The authors concluded that malignant papillary mesothelioma of the tunica vaginalis testis must also be considered when diagnosing tumors that cause pagetoid changes in the epidermis.

Topics

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

Medical terms in this study, explained in our Lexicon: Well-Differentiated Papillary Mesothelioma, Tunica Vaginalis, Mesothelium.

Related studies

• Cutaneous Metastases From Malignant Mesothelioma of the Tunica Vaginalis Testis — P. Hispán, J.C. Pascual, et al. (2016)
• Cutaneous manifestations of malignant mesothelioma of the tunica vaginalis testis — H.J. van der Rhee, W.A. van Vloten, et al. (1983)
• Cutaneous recurrence of malignant mesothelioma of the tunica vaginalis testis: a rare case report — P. Priester, J. Kopecký, et al. (2012)
• Well differentiated (benign) papillary mesothelioma of the tunica vaginalis — R. Chetty (1992)
• Well-Differentiated Papillary Mesothelioma of the Tunica Vaginalis: Case Report and Systematic Review of Literature — W.K. Tan, M.Y. Tan, et al. (2016)
• Papillary serous carcinoma of the tunica vaginalis testis — P. Becerra, M.A. Isaac, et al. (2000)

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