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Case report
peer-reviewed

Malignant Mesothelioma of Tunica Vaginalis Testis: Macroscopic and Microscopic Features of a Very Rare Malignancy



Abstract

Malignant mesothelioma of the tunica vaginalis testis (MMTVT) is an extremely rare tumour, usually mimicking benign pathologies of the scrotum.

Our case is an 84-year-old male patient who appealed with a painless, left-sided scrotal swelling longer than 2 months. Although the level of tumour markers was normal, ultrasonographic examination results forced us to perform an inguinal scrotal exploration. Multiple small papillary tumours, both on tunica vaginalis and tunica albuginea, were detected intraoperatively. Due to these findings, radical orchiectomy was performed.

A pathological evaluation showed malignant mesothelioma (MM) of the tunica vaginalis testis. Exposure to asbestos is a well-known risk factor. Furthermore, a history of trauma, herniorrhaphy and chronic hydroceles is blamed as a possible risk factor. Scrotal ultrasonography is the mainstay of primary diagnosis and, therefore, it should not be overlooked when dealing with benign scrotal cysts or hydroceles, which are very common pathologies at these decades, too.

Radical inguinal orchiectomy is the primary treatment choice for localised MMTVT disease, whereas in signs of lymph node metastasis, inguinal lymph node dissection is required. Radical resection should be completed with chemotherapy and/or radiotherapy for an advanced or recurrent disease. This case, which is very rarely reported in the literature and detected during inguinal exploration, along with the pathological works that supported the diagnosis, was presented with this report.



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Case report
peer-reviewed

Malignant Mesothelioma of Tunica Vaginalis Testis: Macroscopic and Microscopic Features of a Very Rare Malignancy


Author Information

Ersan Arda

Urology, Trakya University

Mehmet Gürkan Arıkan Corresponding Author

Urology, Trakya University Medical Faculty

Gizem Cetin

Anesthesiology, Trakya University Medical Faculty

Uğur Kuyumcuoğlu

Urology, Trakya University

Urology, Trakya University

Ufuk Usta

Pathology, Trakya University Medical Faculty


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Consent was obtained by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.


Case report
peer-reviewed

Malignant Mesothelioma of Tunica Vaginalis Testis: Macroscopic and Microscopic Features of a Very Rare Malignancy


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Case report
peer-reviewed

Malignant Mesothelioma of Tunica Vaginalis Testis: Macroscopic and Microscopic Features of a Very Rare Malignancy

Ersan Arda">Ersan Arda, Mehmet Gürkan Arıkan">Mehmet Gürkan Arıkan , Gizem Cetin">Gizem Cetin, Uğur Kuyumcuoğlu">Uğur Kuyumcuoğlu, Ufuk Usta">Ufuk Usta

  • Author Information
    Ersan Arda

    Urology, Trakya University

    Mehmet Gürkan Arıkan Corresponding Author

    Urology, Trakya University Medical Faculty

    Gizem Cetin

    Anesthesiology, Trakya University Medical Faculty

    Uğur Kuyumcuoğlu

    Urology, Trakya University

    Urology, Trakya University

    Ufuk Usta

    Pathology, Trakya University Medical Faculty


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

    Acknowledgements


    Article Information

    Published: November 19, 2017

    DOI

    10.7759/cureus.1860

    Cite this article as:

    Arda E, Arıkan M, Cetin G, et al. (November 19, 2017) Malignant Mesothelioma of Tunica Vaginalis Testis: Macroscopic and Microscopic Features of a Very Rare Malignancy. Cureus 9(11): e1860. doi:10.7759/cureus.1860

    Publication history

    Received by Cureus: October 21, 2017
    Peer review began: November 03, 2017
    Peer review concluded: November 15, 2017
    Published: November 19, 2017

    Copyright

    © Copyright 2017
    Arda et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Malignant mesothelioma of the tunica vaginalis testis (MMTVT) is an extremely rare tumour, usually mimicking benign pathologies of the scrotum.

Our case is an 84-year-old male patient who appealed with a painless, left-sided scrotal swelling longer than 2 months. Although the level of tumour markers was normal, ultrasonographic examination results forced us to perform an inguinal scrotal exploration. Multiple small papillary tumours, both on tunica vaginalis and tunica albuginea, were detected intraoperatively. Due to these findings, radical orchiectomy was performed.

A pathological evaluation showed malignant mesothelioma (MM) of the tunica vaginalis testis. Exposure to asbestos is a well-known risk factor. Furthermore, a history of trauma, herniorrhaphy and chronic hydroceles is blamed as a possible risk factor. Scrotal ultrasonography is the mainstay of primary diagnosis and, therefore, it should not be overlooked when dealing with benign scrotal cysts or hydroceles, which are very common pathologies at these decades, too.

Radical inguinal orchiectomy is the primary treatment choice for localised MMTVT disease, whereas in signs of lymph node metastasis, inguinal lymph node dissection is required. Radical resection should be completed with chemotherapy and/or radiotherapy for an advanced or recurrent disease. This case, which is very rarely reported in the literature and detected during inguinal exploration, along with the pathological works that supported the diagnosis, was presented with this report.



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Ersan Arda, M.D., Assistant Professor

Urology, Trakya University

Mehmet Gürkan Arıkan

Urology, Trakya University Medical Faculty

For correspondence:
mgarikan26@gmail.com

Gizem Cetin

Anesthesiology, Trakya University Medical Faculty

Uğur Kuyumcuoğlu

Urology, Trakya University

Ufuk Usta

Pathology, Trakya University Medical Faculty

Ersan Arda, M.D., Assistant Professor

Urology, Trakya University

Mehmet Gürkan Arıkan

Urology, Trakya University Medical Faculty

For correspondence:
mgarikan26@gmail.com

Gizem Cetin

Anesthesiology, Trakya University Medical Faculty

Uğur Kuyumcuoğlu

Urology, Trakya University

Ufuk Usta

Pathology, Trakya University Medical Faculty