ABSTRACT
Objective To study the clinical and pathological features, diagnosis and treatment of malig-nant mesothelioma of the tunica vaginalis testis. Methods One case of malignant mesothelioma of the tuni-ca vaginalis testis was reported. The patient was a 73 years old man, presented with a history of aggravated hydrocele for 1 year. B-ultrasound showed 7.5 cm×4.1 cm liquid anechoic area around the testis. The Pubmed and CBM databases were searched for related articles, and the clinical data were reviewed. Results An operation was performed to incise the tunica vaginalis. The pathology showed fecal caneeration in the tunica vaginalis testis and the immunohistology showed CK5/6, Calretinin and E-cadlberin positive. Right or-chiectomy was performed after three weeks. Local tumor recurrence and inguinal lymph nodes metastasis were found 11 months after operation, and local tumor and lymph nodes were resected. The tumor was diagnosed as malignant mesothelioma of the tunica vaginalis testis and CK5/6 and Calretinin fecal positive. Conclu-sions Malignant mesothelioma of the tunica vaginalis is a rare disease of the testis with potentially aggres-sive behavior. Due to the lack of tumor markers and characteristic symptoms, correct preoperative diagnosis is extremely difficult. Radical surgical treatment is of major importance to the survival of the patients. Life-long follow-up should be offered to patients with malignant mesothelioma of the tunica vaginalis.
ABSTRACT
Objective To review the clinical manifestation,pathological characteristics,treat ment and prognosis of malignant mesothelioma of the tuniea vaginalis testis.Methods A case of ma lignant mesothelioma of the tunica vaginalis testis was reported and relative literature was reviewed.A34 year old man was admitted to hospital with a history of aggravated hydroeele for 5 years.A hardtumor was palpated above the right testis,which was smooth and slight tenderness.The level of β-hCG and AFP was normal.Ultrasonography revealed a 2.05 cm× 1.97 cm,well demarcated,mixedecho tumor.Results An operation was performed to incise the tumor and tunica vaginalis undersubarachnoid space block anesthesia.The tumor was histologically diagnosed as low potential malig nant mesothelioma of the tunica vaginalis testis.Microscopic examination showed that the tumor wasmalignant with a biphasic pattern composed of epithelial and stromal components.The former compo nent was dominant.The epithelial cells proliferated obviously with atypia and mitosis.Immunohisto chemical staining showed cytokeratin and vimentin were strongly positive.The capillary,lymph ves sel,spermatic cord and testis were not infiltrated.Right radical orchiectomy and right scrotectomywas performed one month after the first operation.There was no evidence of relapse during 38 monthfollow up after operation.Conclusions The major symptom of patients with malignant mesotheliomais hydrocele,malignant mesothelioma is diagnosed by histopathology.Due to the invasive potential ofthis disease and the risk of tumor recurrence,radical orchiectomy and close follow up are strongly rec ommended.