Pre-operative diagnosis of malignant mesothelioma of tunica vaginalis testis by hydrocele fluid cytology

Our plain-English summary of Pre-operative diagnosis of malignant mesothelioma of tunica vaginalis testis by hydrocele fluid cytology, by S.C. Gupta, A.K. Gupta, V. Misra, et al (European Journal of Surgical Oncology, 1998).

The study

• Authors: S.C. Gupta, A.K. Gupta, V. Misra, P.A. Singh
• Journal: European Journal of Surgical Oncology
• Published: 1998;24(2):153-4
• Type of article: Case report
• Cited by: 11 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Malignant mesothelioma of tunica vaginalis testis is a rare tumour usually associated with hydrocele. Until now only one case has been documented, where a pre-operative diagnosis was made by cytological examination of hydrocele fluid. We report one more case with pre-operative diagnosis using hydrocele fluid cytology.

In plain English

This case report from Allahabad, India, described a 36-year-old man with a rapidly growing right-sided hydrocele (fluid around the testis) of one month's duration. Cells in about 350 ml of drained fluid were malignant and suggestive of malignant mesothelioma of the tunica vaginalis testis, the lining around the testis. Two weeks later the right testis was removed. Microscopy and immunocytochemistry confirmed malignant mesothelioma, with tumour cells in lymph channels. Lymphangiography and CT of the para-aortic and iliac lymph nodes were negative. The article reported no history of asbestos exposure and a normal chest X-ray. Eight months later cancer appeared in groin lymph nodes, and CT showed enlarged para-aortic nodes. Supraclavicular and neck nodes and fluid around both lungs followed, and the patient died of cardiopulmonary arrest. The authors called this probably the second reported case diagnosed before surgery from hydrocele fluid. They concluded that such early diagnosis may help prognosis and treatment of this tumour, because complete surgical resection is possible at this site, unlike mesotheliomas of the pleura or pericardium.

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
• Who was studied: One 36-year-old man with a rapidly growing right-sided hydrocele of 1 month's duration, seen at MLN Medical College, Allahabad, India
• Exposure: No asbestos exposure was reported for this patient; his chest X-ray was normal
• Main results:
  • Cell examination of the roughly 350 ml of hydrocele fluid drained before surgery showed malignant cells suggestive of malignant mesothelioma
  • After removal of the right testis (orchidectomy), microscopy and immunocytochemistry confirmed malignant mesothelioma: EMA, CEA, desmin and S100 were negative; vimentin and cytokeratin were focally positive
  • Tumour emboli were seen in lymphatics, but lymphangiography and CT of para-aortic and iliac lymph nodes were negative at that time
  • Eight months later the patient had enlarged right inguinal lymph nodes containing similar malignant cells, and a CT scan showed enlarged para-aortic lymph nodes
  • The disease then spread to the supraclavicular and cervical lymph nodes, with bilateral pleural effusion; the patient died of cardiopulmonary arrest
• The authors' conclusion: The authors concluded that early diagnosis by cytological examination of hydrocele fluid may prove helpful for prognosis as well as treatment of malignant mesothelioma of the tunica vaginalis testis, because complete surgical resection is possible at this site, in contrast to malignant mesotheliomas of the pleura or pericardium

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma, Tunica Vaginalis, Hydrocele, Fluid Cytology.

Related studies

• Malignant mesothelioma of the tunica vaginalis testis: report of first case with preoperative diagnosis — L. Japko, A.A. Horta, et al. (1982)
• Papillary serous carcinoma of the tunica vaginalis testis — P. Becerra, M.A. Isaac, et al. (2000)
• 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)
• Fine needle aspiration cytology in malignant mesothelioma of the tunica vaginalis testis — R. Gupta, P. Dey, et al. (2011)
• 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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