Well-differentiated papillary mesothelioma of the epididymis in a man with recurrent haematospermia

Our plain-English summary of Well-differentiated papillary mesothelioma of the epididymis in a man with recurrent haematospermia, by L.R. Bonetti, L. Schirosi, G. Sartori, et al (Andrologia, 2012).

The study

• Authors: L.R. Bonetti, L. Schirosi, G. Sartori, M. Lupi, A. Maiorana
• Journal: Andrologia
• Published: 2012;44(4):285-7
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

We present a case of well-differentiated papillary mesothelioma of the epididymis occurring in a 60-year-old man who came to urologic consult after recurrent episodes of haematospermia. The patient denied pain, fever and trauma in genitals. Local examination revealed indolent swelling at the right testicle and ecography localised a well-circumscribed nodule at the epididymis tail, measuring 2 cm in greater diameter, with associated haemorrhagic hydrocele. A nodulectomy was performed and the patient is alive with no evidence of disease 17 months following surgery.

© 2012 Blackwell Verlag GmbH.

In plain English

This short communication was a case report about one 60-year-old man who saw a urologist after repeated episodes of blood in his semen (haematospermia). Ultrasound of a painless swelling at his right testicle showed a well-circumscribed 2 cm nodule at the tail of the epididymis, with a blood-filled fluid collection (haemorrhagic hydrocele). Urine, PSA and semen tests were normal, as were a prostate ultrasound, an abdominal CT scan and a chest X-ray. The nodule was surgically removed and diagnosed under the microscope as well-differentiated papillary mesothelioma. The authors judged it not malignant because it lacked features such as stromal invasion. No recurrence or spread was seen in the 17 months after surgery. No history of injury or asbestos exposure was declared, and no chronic inflammation was seen. Citing other studies, the authors noted that asbestos exposure has been reported in about 30% of patients with this tumour; that figure does not come from this case. The authors stated that, to their knowledge, this tumour had never been described with haematospermia. They considered resection with careful long-term follow-up an adequate standard approach.

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 (short communication)
• Who was studied: One 60-year-old man with recurrent haematospermia; the authors are from the University of Modena and Reggio Emilia, Italy
• Exposure: No history of trauma (insults) or asbestos exposure was declared for this patient
• Main results:
  • Ultrasound (echography) found a well-circumscribed nodule at the tail of the epididymis, 2 cm in greatest diameter, with a haemorrhagic hydrocele
  • Urinalysis, urine culture and PSA results were normal
  • Semen analysis and semen culture before surgery showed no abnormalities
  • Transrectal ultrasound of the prostate, contrast CT scan of the abdomen and chest X-ray were within the normal range
  • The removed nodule was diagnosed as well-differentiated papillary mesothelioma
  • Malignancy was excluded on microscopic features
  • No local recurrence or distant metastasis was seen in the 17 months after surgery
  • No chronic inflammation was observed in this patient
• The authors' conclusion: The authors stated that, to their knowledge, this tumour had not previously been described with haematospermia. They considered it a tumour of low malignant potential, for which resection with careful long-term follow-up is an adequate standard approach.

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, Epididymis, Hydrocele.

Related studies

• An incidental diagnosis of well-differentiated papillary mesothelioma in a woman operated on for recurrent endometriosis — R. Mangal, O. Taskin, et al. (1995)
• Well-differentiated papillary mesothelioma with invasive foci — A. Churg, T. Allen, et al. (2014)
• BAP1 loss is unusual in well-differentiated papillary mesothelioma and may predict development of malignant mesothelioma — H.E. Lee, J.R. Molina, et al. (2018)
• Well-differentiated papillary mesothelioma of the peritoneum: a separate entity — K. Hoekman, G. Tognon, et al. (1996)
• Well-differentiated papillary mesothelioma of the peritoneum: a diagnostic dilemma on fine-needle aspiration cytology — J.G. Nasit, G. Dhruva (2014)
• Well-differentiated papillary mesothelioma — K.J. Butnor, T.A. Sporn, et al. (2001)

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