Papillary serous carcinoma of the tunica vaginalis testis

Our plain-English summary of Papillary serous carcinoma of the tunica vaginalis testis, by P. Becerra, M.A. Isaac, B. Márquez, et al (Pathology, Research and Practice, 2000).

The study

• Authors: P. Becerra, M.A. Isaac, B. Márquez, J.L. Garcia-Puche, A. Zuluaga, F.F. Nogales
• Journal: Pathology, Research and Practice
• Published: 2000;196(11):781-782; discussion 780
• Type of article: Case report
• Cited by: 11 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

This is a case report of a testicular papillary serous carcinoma of ovarian type (PSCOT) diagnosed in a 50-year-old man. The tumor presented in the form of multiple papillary exophytic excrescencies on the visceral tunica vaginalis testis lining the inner surface of a hydrocele sac. The tumor was histologically a papillary serous carcinoma with numerous psammoma bodies, indistinguishable from similar tumors arising on the surface of the ovary. Following the tumor's surgical removal, the patient was treated with the same drugs used to treat ovarian serous carcinomas, and he is alive two years after the initial diagnosis. PSCOT must be distinguished from mesothelioma of the tunica vaginalis testis, a tumor with a most unfavorable prognosis. As shown here, immunohistochemical findings can be useful for formulating the correct diagnosis of PSCOT.

In plain English

This case report from University Hospital, Granada, Spain, described one 50-year-old man treated for a hydrocele (fluid around the testis). During repair surgery, multiple small papillary tumor growths were found on the tunica vaginalis, the lining around the testis, and the testis was then removed. Under the microscope the tumor looked like serous carcinoma of the ovary, with numerous psammoma bodies. It had small invasive areas in the albuginea, but the testicular tissue was not involved. Staining was positive for markers typical of ovarian epithelial tumors and negative for mesothelioma markers such as calretinin and thrombomodulin. After 6 cycles of cyclophosphamide, adriamycin and cisplatin, the patient was alive and well two years later. The authors stated that this tumor must be told apart from mesothelioma of the tunica vaginalis, which they described as more malignant and generally linked to older age and a history of asbestos exposure. The article does not say whether this patient had any asbestos exposure. The authors concluded that immunohistochemistry was useful in this case, though it may not be entirely reliable for this distinction.

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 50-year-old man with a hydrocele, seen at University Hospital, Granada, Spain; year of diagnosis not stated
• Exposure: No asbestos exposure was studied or reported for this patient. Asbestos is mentioned only as a general feature that helps distinguish mesothelioma of the tunica vaginalis testis (MMVT) from this tumor.
• Main results:
  • Multiple foci of a papillary tumor were found on the tunica vaginalis testis during reparative surgery for the hydrocele.
  • Small invasive foci were seen in the albuginea, but the testicular parenchyma was not involved. Psammoma bodies were present.
  • The tumor was negative for the mesothelioma markers HBME-1, thrombomodulin, calretinin and N-cadherins. It was positive for cytokeratin 7, CAM 5.2, EMA, CEA, Ber-EP4, CA 125, CA 19.9, LeuM1 and S-100.
  • After orchidectomy and 6 cycles of cyclophosphamide, adriamycin and cisplatin, the patient was alive and well two years later, with CA 125 levels within normal limits and no evidence of recurrence so far.
• The authors' conclusion: The authors concluded that immunohistochemistry was most useful in this case for diagnosing this rare tumor. They also suggested that testicular PSCOT may respond well to the drugs used against equivalent ovarian carcinomas.
• Limitations the authors state:
  • The authors noted that immunohistochemistry may not be entirely reliable in distinguishing PSCOT from mesothelioma of the tunica vaginalis.
  • The authors noted that, because the tumor is rare, there are no generally accepted treatment protocols.

Topics

Medical terms in this study, explained in our Lexicon: Carcinoma, Tunica Vaginalis, Hydrocele, Ovarian Serous Carcinoma, Mesothelioma, Prognosis.

Related studies

• Immunohistochemical profile of paratesticular serous papillary adenocarcinoma and tunica vaginalis facilitates distinction from malignant mesothelioma — P.R. Anchala, R. Dhir, et al. (2011)
• Malignant mesothelioma of the tunica vaginalis testis: a rare case and review of literature — M. Drevinskaite, A. Patasius, et al. (2020)
• Pre-operative diagnosis of malignant mesothelioma of tunica vaginalis testis by hydrocele fluid cytology — S.C. Gupta, A.K. Gupta, et al. (1998)
• 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)
• 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 testis: report of first case with preoperative diagnosis — L. Japko, A.A. Horta, et al. (1982)

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