Malignant mesothelioma of the tunica vaginalis. Report of a case without risk factors and review of the literature

Our plain-English summary of Malignant mesothelioma of the tunica vaginalis. Report of a case without risk factors and review of the literature, by A. García de Jalón, P. Gil, J. Azúa-Romeo, et al (International Urology and Nephrology, 2003).

The study

• Authors: A. García de Jalón, P. Gil, J. Azúa-Romeo, A. Borque, C. Sancho, L.A. Rioja
• Journal: International Urology and Nephrology
• Published: 2003;35(1):59-62
• Type of article: Case report, Review
• Cited by: 20 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Malignant mesothelioma of the tunica vaginalis testis is an aggressive tumour with local recurrence being distant metastases the main feature of the clinical course. Usually appears over the fourth decade, having a strong relationship with occupational exposure to asbestos and long lasting hydrocele. We introduce a case of a 78-year-old caucasian male who developed a malignant mesothelioma without personal history of hydrocele or exposure to asbestos. A revision of the current literature is performed to summarize the recent therapeutic options as well as new diagnostic tools.

In plain English

This article was a case report with a short review of published literature, written by doctors in the Departments of Urology and Pathology at Miguel Servet University Hospital in Zaragoza, Spain. The patient was a 78-year-old retired carpenter who had a one-month history of swelling of the right scrotum and of the penis. Ultrasound showed a fluid collection around the right testis (a hydrocele). Surgeons removed the right testis through the groin. Examination of the tissue showed malignant mesothelioma of the tunica vaginalis, the lining around the testis, which had grown into nearby parts of the testis. A CT scan showed a mass of lymph nodes at the back of the abdomen, which was treated with radiotherapy. At the time of writing, the patient had been followed for 3 months and the response to radiotherapy had not yet been assessed. The authors stated that the patient had no history of asbestos exposure or of hydrocele. The article did not describe how his exposure history was assessed. The authors concluded that doctors should be aware of this tumour even when there are no evident risk factors.

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 one patient, with a brief review of the literature on diagnosis and treatment
• Who was studied: One 78-year-old Caucasian man, a retired carpenter, seen by the authors' urology and pathology departments at Miguel Servet University Hospital, Zaragoza, Spain. The date of treatment was not stated.
• Exposure: The authors reported that the patient had no asbestos exposure and no history of hydrocele, and did not belong to a risk group. No fiber types are discussed for this patient.
• Main results:
  • The patient had a one-month history of increased volume of the right scrotum with swelling (edema) of the penis. Ultrasound showed a moderately sized right hydrocele of loculated appearance.
  • A right inguinal orchidectomy (removal of the testis through the groin) was performed.
  • Pathology showed a biphasic malignant tumour. On immunostaining it was strongly reactive for cytokeratin (AE1-AE3) and vimentin, focally positive for epithelial membrane antigen, and positive for calretinin.
  • The diagnosis was malignant mesothelioma of the tunica vaginalis, with infiltration into the epididymis, rete testis and testicular parenchyma.
  • CT of the abdomen showed a retroperitoneal lymph node mass causing moderate left ureterohydronephrosis (swelling of the left kidney and ureter).
  • The lymph node mass was treated with adjuvant retroperitoneal radiotherapy. After 3 months of follow-up, the response had not yet been evaluated.
• The authors' conclusion: The authors concluded that, given the tumour's aggressive behaviour, difficult preoperative diagnosis and need for radical treatment, doctors should be aware of it even when evident risk factors are absent. They described cytology of the mass as a very effective tool and stated that treatment should be radical surgery.

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, Occupational Exposure, Hydrocele.

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