Well-differentiated papillary mesothelioma of the tunica vaginalis: a case study and review of the literature

Our plain-English summary of Well-differentiated papillary mesothelioma of the tunica vaginalis: a case study and review of the literature, by S. Erdogan, A. Acikalin, H. Zeren, et al (Korean Journal of Pathology, 2014).

The study

• Authors: S. Erdogan, A. Acikalin, H. Zeren, G. Gonlusen, S. Zorludemir, V. Izol
• Journal: Korean Journal of Pathology
• Published: 2014;48(3):225-8
• Cited by: 15 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Well-differentiated papillary mesothelioma is an uncommon tumor of the testes that usually presents as a hydrocele. Here, we present the case of one patient who did not have a history of asbestos exposure. The tumor was localized in the tunica vaginalis and was composed of three pedunculated masses macroscopically. Microscopically, branching papillary structures with focal coagulative necrosis were present. In addition to immunohistochemistry, simian virus 40 DNA was also tested by polymerase chain reaction. This report presents one case of this rare entity, its clinical and macroscopic features, and follow-up results.

In plain English

This was a case report of one patient with well-differentiated papillary mesothelioma (WDPM), a rare tumor, in the tunica vaginalis (the lining around the testis), with a review of published cases. A 48-year-old man had scrotal pain and swelling for 6 months. Ultrasound showed a left hydrocele (fluid around the testis) with three nodules. He had no history of trauma or asbestos exposure, and his left testis was removed. Under the microscope the masses had branching papillary structures lined by bland cells, a focal area of dead tissue (coagulative necrosis), and no invasion. No simian virus 40 (SV40) DNA was found. The article reported no residual disease 3 years after surgery and, elsewhere, 4 years of uneventful follow-up. Reviewing the literature, the authors stated that one earlier case had a history of asbestos exposure and one had household contact. The authors concluded that hydrocele seems to be the major risk factor for this tumor, and that its behavior is not well known because so few cases exist.

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 review of previously published cases of paratesticular well-differentiated papillary mesothelioma
• Who was studied: One 48-year-old man with scrotal pain and swelling for 6 months, treated at Cukurova University, Adana, Turkey
• Exposure: The patient had no history of trauma or asbestos exposure. The tumor was also tested for simian virus 40 (SV40) DNA.
• Main results:
  • Ultrasound showed a left hydrocele containing three nodules measuring 2 cm, 1.4 cm and 0.9 cm
  • A left radical orchiectomy (removal of the testis) was performed
  • In the removed tissue, the tunica vaginalis had three pedunculated (stalked) masses of 2 cm, 1.5 cm and 1 cm
  • The papillary structures were lined by a single layer of bland cuboidal cells
  • Focal areas had a complex pattern but no subepithelial invasion
  • Focal coagulative necrosis was present
  • The tumor cells showed diffuse calretinin positivity
  • No SV40 DNA was detected by polymerase chain reaction in this patient's tumor
  • Follow-up: no signs of residual disease 3 years after surgery
  • Follow-up: the discussion reports 4 years of uneventful follow-up
  • In the literature review, the authors stated that one previously reported case of WDPM of the tunica vaginalis had a history of asbestos exposure and one had a household contact with exposure
• The authors' conclusion: The authors concluded that, taking all reported cases into consideration, hydrocele seems to be the major risk factor for developing WDPM of the tunica vaginalis, and that its biologic behavior is not well known because of the limited number of cases.
• Limitations the authors state:
  • The authors stated that experience in telling WDPM apart from malignant mesothelioma with dominant papillary growth is limited, with only 18 known cases in the literature
  • The authors stated that the biologic behavior of paratesticular WDPM is not well known because of the limited number of cases

Topics

Medical terms in this study, explained in our Lexicon: Well-Differentiated Papillary Mesothelioma, Tunica Vaginalis, Hydrocele, Asbestos Exposure, Necrosis, Immunohistochemistry.

Related studies

• Well-Differentiated Papillary Mesothelioma of the Tunica Vaginalis: Case Report and Systematic Review of Literature — W.K. Tan, M.Y. Tan, et al. (2016)
• Case Report of a Well-Differentiated Papillary Mesothelioma of the Tunica Vaginalis in an Undescended Testis With Review of Literature — P. Parcesepe, S. Sina, et al. (2016)
• Well differentiated (benign) papillary mesothelioma of the tunica vaginalis — R. Chetty (1992)
• Well-differentiated Papillary Mesothelioma of the Tunica Vaginalis — W.K. Tan, M.Y. Tan, et al. (2016)
• Well-differentiated papillary mesothelioma of tunica vaginalis testis of unknown malignant potential: Sonographic appearance — K.W.S. Ko, K.S. Tse, et al. (2018)
• Well-differentiated papillary mesothelioma of the peritoneum: a pathological analysis and review of the literature — A.V. Hoekstra, M.W. Riben, et al. (2005)

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