Idiopathic chronic hematocele mimicking a mesothelioma of the tunica vaginalis testis

Our plain-English summary of Idiopathic chronic hematocele mimicking a mesothelioma of the tunica vaginalis testis, by M. Bibi, A. Sellami, T. Taktak, et al (Urology Case Reports, 2018).

The study

• Authors: M. Bibi, A. Sellami, T. Taktak, A.Z. Kassar, M.A.B. Chehida, K. Chaker, K. Abid, S.B. Rhouma, Y. Nouira
• Journal: Urology Case Reports
• Published: 2018;20:104-105
• Type of article: Case report
• Read it: PubMed · Publisher · Free full text

In plain English

This article was a case report from the Department of Urology at La Rabta Hospital in Tunisia describing one patient. A 57-year-old man had a painless swelling of the scrotum for 2 years. The authors reported that he had no history of asbestos exposure or of any surgery. Blood tumor markers (αFP, HCG and LDH) were not elevated, and a chest X-ray was normal. Ultrasound showed a large fluid collection on the right side (hydrocele) and a mass outside the testis with solid areas and irregular internal dividing walls. The authors strongly suspected malignant mesothelioma of the tunica vaginalis testis, the lining around the testis, so the right testis was removed through the groin. The removed mass measured 22 × 16 × 8 cm and was filled with brown blood-stained material and fibrin. Microscopic examination found no cancerous features. The final diagnosis was a hematocele, a collection of blood around the testis, and its cause was unknown. The authors concluded that idiopathic hematocele should be considered when doctors work out the possible causes of a scrotal mass.

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)
• Who was studied: One 57-year-old man with a painless scrotal swelling for 2 years, treated at La Rabta Hospital, Tunisia; the date of treatment is not stated
• Exposure: None. The patient had no history of asbestos exposure or of previous surgery.
• Main results:
  • In this patient, tumor markers (αFP, HCG, LDH) were not elevated and chest radiography was normal
  • Ultrasound showed a large right hydrocele and a mass outside the testis
  • The authors highly suspected malignant mesothelioma of the tunica vaginalis testis and performed a right radical inguinal orchidectomy (removal of the right testis through the groin)
  • The resected mass measured 22 × 16 × 8 cm
  • Microscopic examination found no epithelial proliferation, cellular atypia or malignant features; the mass contained hemorrhagic material and fibrin without evidence of neoplasia, and the final diagnosis was hematocele
  • The cause of the hematocele in this patient was unknown
• The authors' conclusion: The authors concluded that idiopathic hematocele should be considered in the differential diagnosis of scrotal masses

Topics

Medical terms in this study, explained in our Lexicon: Idiopathic, Mesothelioma, Tunica Vaginalis.

Related studies

• 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 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 — K. Antman, S. Cohen, et al. (1984)
• Epidemiology of mesothelioma of the pericardium and tunica vaginalis testis — G. Mezei, E.T. Chang, et al. (2017)
• Malignant mesothelioma of the tunica vaginalis testis: diagnostic studies and differential diagnosis — S.S. Chekol, C.C. Sun (2012)
• Malignant mesothelioma of the tunica vaginalis testis: a rare case and review of literature — M. Drevinskaite, A. Patasius, et al. (2020)

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