Malignant mesothelioma of the tunica vaginalis

Case report of a new case of malignant mesothelioma of the tunica vaginalis testis. A mediterranean male age 62, presented with enlargement and swelling of the scrotum, treated as orchiepydidymitis within the previous 3 months. Physical and ultrasonography examination showed a left scrotal mass with extension to the skin of the scrotum. After surgery (orchiectomy and partial hemiscrotectomy) and histopathology diagnosis of locally advanced malignant mesothelioma, CT showed metastasis in retroperitoneum, Lung and Liver. The patient undergoes chemotherapy and radiotheraphy with a poor prognose. We review the diagnosis, histopathology and therapeutical approach for this uncommon kind of paratesticular tumor (less than 80 cases reported in the last 30 years).     

Malignant mesothelioma of the tunica vaginalis testis

Malignant mesothelioma of the tunica vaginalis is an extremely rare tumor. Appropriate treatment consists of inquinal orchiectomy with close followup. Treatment of locally recurrent malignant mesothelioma of the tunica vaginalis has not been standardized. We recommend radical resection for the initial presentation of locally recurrent disease rather than saving surgical resection as salvage therapy after other treatment modalities have failed. We report case 37 of malignant mesothelioma of the tunica vaginalis and review the literature.     

Malignant mesothelioma of tunica vaginalis testis

Malignant mesothelioma of the tunica vaginalis is rare, but sometimes curable. It is similar to malignant mesothelioma of the peritoneum and of the pleura, and is likewise associated with asbestos exposure. We report a case, with correlative computed tomography, ultrasound, and gross pathology images that demonstrate tiny tumor implants studding the vaginalis testis. The literature is reviewed.     

Malignant mesothelioma of testicular tunica vaginalis

We report here a case with malignant mesothelioma of testicular tunica vaginalis. An 81-year-old Japanese man with left hydrocele was referred for operation. When hydrocelectomy was performed, a thick wall of tunica vaginalis without malignancy was observed. Seven months after hydrocelectomy, a hard irregular mass was noticed in the left scrotum, therefore inguinal orchiectomy was performed. Pathologically, the mass showed severe atypia and mitosis. The diagnosis of malignant mesothelioma was made. He refused any adjuvant treatment and died 1 year later from multiple metastases to the paraaortic lymph nodes and lumbar supine.     

Malignant mesothelioma of the tunica vaginalis testis

A 74-year-old man underwent hydrocelectomy following repeated fluid aspiration, six times during the previous year. Tunica vaginalis was opened after removing about 70 ml of yellow clear fluid and many miliary sized soft papillary tumors were seen inside of the vaginal sac. These tumors were attached to the sac so closely that they were easily rubbed off with a towel. The pathological specimen showed a papillary structure combined with solid sheets of cells. The cells were cuboidal and polygonal with sparse mitotic figures and the nuclei were round or oval with prominent nucleoli. Malignancy was strongly suspected and orchiectomy was performed a month later. Pathologic examination of the operated material showed that the tumor cells invaded into the tunica albuginea, and the diagnosis of malignant mesothelioma was finally made. The patient has remained well with neither recurrence nor metastasis for fifteen months.     

Malignant papillary mesothelioma of tunica vaginalis testis

A malignant papillary mesothelioma of the tunica vaginalis testis with retroperitoneal lymph node and pulmonary metastases is reported in a seventy-seven-year-old man. Electron microscopy of a local recurrence documented its mesothelial origin. The clinical and pathologic features of these rare neoplasms are discussed.     

Asbestos-induced malignant mesothelioma of the tunica vaginalis testis

Since 1977 the diffuse malignant mesothelioma of the pleura and peritoneum caused by asbestos represents one of the most often compensated occupational cancers in Germany. Because of the probability of an asbestos-related etiology, it is considered as a "signal tumour", mainly indicating exposure to asbestos dust at the workplace. Two cases of histologically confirmed rare malignant mesothelioma of the tunica vaginalis testis are presented. Previous exposure to asbestos at the workplace is to be considered as a causal factor in both tumors. If cases of mesothelioma occur the criteria for indicating an occupational disease (No. 4105 of the German Law of Occupational Diseases, BKV) are fulfilled.     

Malignant mesothelioma of the tunica vaginalis testis]

Malignant mesothelioma of the tunica vaginalis testis is an extremely rare tumor, with only 37 cases previously described in the literature. Treatment consists of inguinal orchiectomy with close follow-up [1]. Asbestos exposure, trauma and hydrocele have been implicated as risk factors. We describe a patient's history and the pathological findings as well as the management according to preceding reports in the literature.     

Extensive palliative surgery for advanced mesothelioma of the tunica vaginalis

Malignant mesothelioma of the tunica vaginalis is a rare tumor managed principally by radical surgical resection. Chemotherapy and radiotherapy have limited efficacy. We report on a 67-year-old man with severe debilitation from multiple scrotal and inguinal recurrences of a malignant mesothelioma originating in the right tunica vaginalis. Local pain from extensive tumor spread prevented ambulation. Aggressive surgical debridement (total penectomy and scrotectomy) and perineal urethrostomy afforded the patient significant improvement in his quality of life before he finally died of the disease 3 years after diagnosis.     

Malignant mesothelioma of the tunica vaginalis: a case report

A 70-year-old man was referred to our hospital with a painless swelling of the light scrotal contents. Ultrasonography and computed tomographic scan revealed a hydrocele testis and irregular masses in the scrotum. The patient underwent left orchidectomy under the diagnosis of left intrascrotal tumor. Pathological diagnosis was malignant mesothelioma. The patient has not received additional therapy because there has been no evidence of metastasis. He has been free of disease 3 months postoperatively.     

Malignant mesothelioma of the tunica vaginalis testis: a case report

We report a case of malignant mesothelioma of the testicular tunica vaginalis. A preceding hydrocele showed mesothelial hyperplasia of its lining. The tumor was treated surgically as well as with a combination of radiotherapy and chemotherapy but it progressed, resulting in death within 21 months from the diagnosis. The relationship of the tumor to mesothelial hyperplasia and to previous exposure to asbestos is discussed.     

Diagnosis and prognosis of malignant mesothelioma of the tunica vaginalis testis

Objectives:

The objective of this study is to evaluate the diagnosis and prognosis of malignant mesothelioma of the tunica vaginalis testis through an additional 6 patients with urogenital mesothelioma.

Methods:

Six patients with urogenital mesothelioma who underwent adequate surgical procedures and histopathologic analysis from 1990 to 2009 were identified and retrospectively reviewed.

Results:

Six patients between the ages of 26 and 78 years with urogenital mesothelioma, 5 of which originated in the scrotum and 1 in the spermatic cord. Histopathologic analysis showed that CK5/6 and calretinin were positive in all cases, 5 cases were positive for vimentin, and 1 case showed focal weak positive reaction with MOC3, but none of the cases stained for CEA or CD15. The overall recurrence rate of urogenital mesothelioma after surgery was 5/6, including local recurrences and fatalities due to tumour.

Conclusions:

In cases of mesothelioma of the tunica vaginalis testis, the histopathologic markers we chose helped confirm the histopathological diagnosis; adequate surgical procedures are typically not curative, and this tumour is often fatal.     

睾丸鞘膜恶性间皮瘤1例报告

目的 探讨睾丸鞘膜恶性间皮瘤的临床特征及诊治方法.方法 报告1例睾丸鞘膜恶性间皮瘤患者的临床资料.男性,73岁,临床表现右侧阴囊进行性增大1年,B超睾丸周围可见约7.5 cm×4.1 cm液性暗区.检索Pubmed和CBM数据库相关文献进行学习.结果 患者行右侧睾丸鞘膜切除术,术后病理:睾丸鞘膜间皮细胞增生,伴非典型性增生,局灶恶变,免疫组化:CK5/6(+),Calretinin(+),E-cadlherin(+).3周后行右睾丸切除,术后11个月患者出现右侧阴囊肿物及腹股沟淋巴结肿大,行右侧阴囊肿物切除及腹股沟淋巴结切除,术后病理:脂肪结缔组织及纤维组织中恶性间皮瘤浸润,免疫组化:CK5/6(+),Calretinin灶状(+).结论 睾丸鞘膜恶性间皮瘤临床罕见,生物学行为进展快,临床症状不典型,缺少特异性肿瘤标记物,术前诊断较难,诊断主要依据病理,治疗以根治性手术为主,术后需长期严密随访,患者预后差.     

Malignant mesothelioma of the tunica vaginalis testis related to recent asbestos

Abstract:   We report an extremely rare case of malignant mesothelioma in the tunica vaginalis testis. A 67-year-old man was referred to our hospital complaining of painless swelling in the right scrotum. Ultrasonography and computed tomography demonstrated a mass of approximately 6 cm in the right scrotum. He underwent tumor resection under a diagnosis of right intrascrotal tumor. The histopathological diagnosis was malignant mesothelioma, and he died 26 months later from multiple metastases. Asbestos may be a significant contributor to malignant mesothelioma in Japan. There have been 46 cases reported in urology departments in this country of the related symptoms, but only two of these have been clearly attributable to asbestos, which may be due to the investigations being insufficient to obtain a definitive diagnosis. In addition, this symptom is often diagnosed preoperatively as hydrocele testis; it is therefore important to carry out ultrasonography when a hydrocele testis has been diagnosed.     

Case of mesothelioma of the tunica vaginalis testis with characteristic findings on ultrasonography and magnetic resonance imaging.

A case of mesothelioma of the right tunica vaginalis testis in a 32-year-old man is reported. Trans-scrotal ultrasonography revealed hydrocele and multiple nodular masses measuring 1.0-4.5 cm in size attached to the parietal vaginal layer. Magnetic resonance imaging demonstrated more clearly nodular masses with irregular surfaces lined on the hydrocele cavity. Histologic diagnosis of the tumor when orchiectomized was mesothelioma. The patient has been free of disease for approximately 3 years since the treatment.