Abstract. Malignant mesothelioma of the tunica vaginalis testis is an extremely rare tumor without specific clinical manifestations, mainly including hydrocele formation and a painless mass. We herein present the case of a patient with hydrocele of the left testis, without any other complaints. Tunica vaginalis subinvolution was performed, and postoperative pathological examination revealed a malignant mesothelioma arising from the left tunica vaginalis testis. Whole-body positron emission tomography-computed tomography (PET-CT) and subsequent abdominal and pelvic magnetic resonance imaging (MRI) revealed no evidence of local lymphadenopathy. Radical left orchiectomy was performed after the pathological diagnosis. The pathological examination after the second surgery demonstrated that the tumor had invaded the adjacent periorchium and spermatic cord, but there was no evidence of local lymph node metastasis. Pemetrexed and cisplatin were administered at a dose of 900 and 130 mg, respectively, on the first day of a 28-day cycle. After 6 months of therapy, the disease had not progressed on abdominal and pelvic PET-CT and MRI. The patient was still followed up in our urology outpatient clinic at the time of the present report. Although testicular hydrocele is a common and easily diagnosed condition, detailed medical history and physical examination are required. Thus, when clinicians encounter patients with testicular hydrocele, a variety of possible causes must be considered, including testicular or paratesticular tumors, even rare tumors such as mesothelioma of the tunica vaginalis testis.
Krüppel-like factor 4 (KLF4) is a transcription factor and putative tumor suppressor. However, little is known about its role in the progression of prostate cancer. The aim of the present study was to examine the expression and potential role of KLF4 in prostate cancer. KLF4 and E-cadherin expression in 60 prostate cancer tissues and 60 benign prostatic hyperplasia tissues was characterized by immunohistochemistry. The levels of KLF4 expression in prostate cancer cells were determined by reverse transcription-quantitative polymerase chain reaction and western blot analysis. LNCaP cells were transduced with lentivirus to induce KLF4 overexpression. The effects of KLF4 overexpression on proliferation, cell cycle and migration were determined by MTT, flow cytometry, wound healing and Transwell migration assays. KLF4 was identified to be primarily expressed in the cytoplasm of non-tumor prostate tissues. The percentage of KLF4 + tissues among prostate cancer tissues (16.67%) was significantly lower compared with that of non-tumor tissues (84.67%; P<0.05). Downregulated KLF4 expression was associated with higher stage, positive lymph node metastasis and higher Gleason scores of prostate cancer (all P<0.05). Induction of KLF4 overexpression significantly inhibited the proliferation, wound healing and migration of LNCaP cells and induced their cell cycle arrest at S phase. Furthermore, E-cadherin expression was downregulated in prostate cancer tissues and KLF4 overexpression enhanced the levels of E-cadherin expression in LNCaP cells. In conclusion, downregulated KLF4 expression was associated with aggressiveness of prostate cancer, and KLF4 overexpression inhibited the proliferation, wound healing and migration of prostate cancer cells by inducing cell cycle arrest and E-cadherin expression.
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