A rare malignant mesothelioma of the tunica vaginalis testis: A case report

Our plain-English summary of A rare malignant mesothelioma of the tunica vaginalis testis: A case report, by Y. Jiang, Y. Cai, X. Xu, et al (Oncology Letters, 2024).

The study

• Authors: Y. Jiang, Y. Cai, X. Xu, X. Kong, J. Cao
• Journal: Oncology Letters
• Published: 2024;27(4):172
• Type of article: Case report
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Malignant mesothelioma of the tunica vaginalis testis is a rare, highly invasive urogenital malignant tumor with no specific clinical manifestations. Reported cases of this disease are limited. Therefore, an early preoperative diagnosis is difficult. The current study presents a case of malignant mesothelioma of the tunica vaginalis testis and a literature review. A 52-year-old man was admitted to Xiaoshan Affiliated Hospital of Wenzhou Medical University (Hangzhou, China) in December 2022 and underwent radical resection of the right testicle and epididymis but did not undergo radiotherapy or chemotherapy. The patient was followed up for 5 months, and no recurrence or metastasis was found. The rarity of testicular mesothelioma poses a challenge to its etiology and diagnosis, which is rarely achieved preoperatively. Malignant mesothelioma of the testicular tunica vaginalis has a poor prognosis and is not sensitive to radiotherapy or chemotherapy, requiring close postoperative follow-up. This condition is rare in clinical practice; therefore, it needs to be reported to aid clinicians' decision-making regarding diagnosis and treatment.

Copyright: © 2024 Jiang et al.

In plain English

This article was a case report about one man with malignant mesothelioma of the tunica vaginalis testis, the membrane around the testicle. A 52-year-old man came to the urology department of a hospital affiliated with Wenzhou Medical University in China in December 2022 with 2 months of swelling and pain in the right testis. The authors reported that he had no known exposure to asbestos, and noted a long history of hydrocele (fluid around the testicle). A CT scan showed a large hydrocele, and tumor marker tests were normal. After surgery to remove the lesion, tissue examination showed a biphasic mesothelioma, with both epithelial and sarcomatoid parts. Stains for calretinin, CK5/6 and WT-1 were positive. In March 2023 his right testis was removed, and no definite remaining tumor was found. He had been followed up once, with no abnormalities. The authors concluded that this tumor is hard to diagnose before surgery and needs close follow-up after surgery. They noted as a limitation that the staining results were not confirmed with mRNA tests.

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), with discussion of published literature
• Who was studied: One 52-year-old man seen at the Department of Urology of Xiaoshan Hospital, Affiliated with Wenzhou Medical University, China, in December 2022, with 2 months of right testicular swelling and pain
• Exposure: No known asbestos exposure. The authors noted the patient had a long history of hydrocele.
• Main results:
  • Before surgery, the CT scan showed significant hydrocele of the right testicular tunica vaginalis, suggesting epididymitis. Ultrasound showed a cyst in the right epididymis head, and tumor indicators were not abnormal.
  • After resection of the right testicular sheath lesion, the pathological diagnosis was biphasic mesothelioma, with epithelial and sarcomatoid forms.
  • On immunohistochemistry, calretinin, CK5/6, D2-40 and WT-1 were positive. Carcinoembryonic antigen, CD15 and CD34 were negative. Ki-67 was 10%.
  • At a second operation (right orchiectomy) in March 2023, no definite residual tumor was found and the spermatic margin was negative.
  • The patient had been followed up once after surgery, with no abnormalities observed.
• The authors' conclusion: The authors concluded that the rarity of testicular mesothelioma makes its causes and diagnosis challenging, and that diagnosis is rarely made before surgery. They stated that the tumor has a poor prognosis and is not sensitive to radiotherapy or chemotherapy, so close postoperative follow-up is required.
• Limitations the authors state:
  • The positive calretinin, CK5/6 and WT-1 staining was not confirmed by mRNA expression tests such as RT-PCR.

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Tunica Vaginalis, Epididymis, Chemotherapy, Metastasis, Testicular Mesothelioma, Etiology, Prognosis.

Related studies

• 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)
• 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)
• Malignant Mesothelioma of Tunica Vaginalis Testis: Macroscopic and Microscopic Features of a Very Rare Malignancy — E. Arda, M.G. Arıkan, et al. (2017)
• Rare tumors of the testis and mesothelial proliferation in the tunica vaginalis — M. Colecchia, G. Mikuz, et al. (2012)
• Malignant mesothelioma of the tunica vaginalis testis: A rare cause of hydrocele — M. de Sá Barrêto Callou Peixoto, M.K. Bernardo Soares, et al. (2022)

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