Paratesticular malignant mesothelioma associated with abdominoscrotal hydrocele

Our plain-English summary of Paratesticular malignant mesothelioma associated with abdominoscrotal hydrocele, by A.L. Velasco, J. Ophoven, J.R. Priest, et al (Journal of Pediatric Surgery, 1988).

The study

• Authors: A.L. Velasco, J. Ophoven, J.R. Priest, W.S. Brennom
• Journal: Journal of Pediatric Surgery
• Published: 1988;23(11):1065-7
• Type of article: Case report, Review
• Cited by: 42 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

This is the report of 14-year-old boy with a malignant mesothelioma of the tunica vaginalis contained in an abdominoscrotal hydrocele. A review of the literature shows that this aggressive tumor is very rare and has been reported only in adults.

In plain English

This article is a case report of one patient: a 14-year-old boy with a malignant mesothelioma of the tunica vaginalis (the lining around the testicle) contained in a left abdominoscrotal hydrocele, a fluid collection reaching from the scrotum into the abdomen. He had about a year of intermittent constipation and a 14-lb weight loss, then abdominal pain, nausea and vomiting. Doctors found a 20 x 30 cm abdominal mass and a fluid-filled left scrotum. A CT scan showed a cystic mass behind the abdominal lining extending into the scrotum, and it was removed at surgery. Tissue tests were consistent with malignant mesothelioma. A second operation 6 months later found no recurrence, and 2 years after diagnosis he was tumor-free. The article does not say whether he had ever been exposed to asbestos. In their discussion, the authors wrote that asbestos exposure does not seem to be a causative factor in this tumor type. The authors stated that, to their knowledge, this was the first report of a malignant mesothelioma in a child.

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 a single patient, with a brief discussion of previously reported cases
• Who was studied: One 14-year-old white boy, a twin with a healthy brother, seen at St Paul Children's Hospital and the University of Minnesota, St Paul
• Exposure: The article does not say whether the patient had been exposed to asbestos. In the discussion, the authors wrote that asbestos exposure does not seem to be a causative factor in this type of tumor (malignant mesothelioma of the tunica vaginalis).
• Main results:
  • The patient had about 1 year of intermittent constipation and a 14-lb weight loss. Two days before admission he had pain in the left lower abdomen, with nausea and vomiting.
  • On examination, a firm abdominal mass measuring 20 x 30 cm was felt in the left lower abdomen. The left side of the scrotum was distended with fluid, measuring 7 cm.
  • The tumor markers human chorionic gonadotropin and alpha-fetoprotein were normal.
  • A CT scan showed a cystic mass behind the abdominal cavity (retroperitoneal) extending into the scrotum through the left inguinal canal. It was removed at laparotomy. The right testicle was inside the abdomen.
  • Pathology showed an epithelioid-appearing tumor with papillary growth, focal necrosis and invasion. The immunohistochemical panel was consistent with malignant mesothelioma, and the left testicle was separate from the tumor.
  • A second-look laparotomy 6 months after the first operation found no recurrent tumor.
  • Two years after diagnosis, the patient was clinically, radiographically and biochemically tumor-free.
• The authors' conclusion: The authors stated that, to their knowledge, this was the first report of a malignant mesothelioma in a child. They wrote that their literature review found this aggressive tumor to be very rare and previously reported only in adults. They described the long-term outlook as guarded, with complete surgical removal as the best possible treatment.

Topics

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

Medical terms in this study, explained in our Lexicon: Paratesticular, Malignant Mesothelioma, Hydrocele, Tunica Vaginalis.

Related studies

• Pre-operative diagnosis of malignant mesothelioma of tunica vaginalis testis by hydrocele fluid cytology — S.C. Gupta, A.K. Gupta, et al. (1998)
• Multiple mesotheliomas of the hydrocele sac: a case report — C.L. Reynolds (1958)
• Testicular mesothelioma disguised as hydrocele: a case report — T. Nazar, A. Gopalakrishnabhaktan, et al. (2024)
• Malignant mesothelioma of the tunica vaginalis testis: report of first case with preoperative diagnosis — L. Japko, A.A. Horta, et al. (1982)
• Malignant mesothelioma of the tunica vaginalis testis: a rare case and review of literature — M. Drevinskaite, A. Patasius, et al. (2020)
• 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)

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