Clinical Features and Outcomes of Tunica Vaginalis Mesothelioma: A Case Series From the National Institutes of Health

Abstract

OBJECTIVE To present our single-institution experience with management of seven patients with mesothelioma of the tunica vaginalis. MATERIALS AND METHODS Our institution database was queried from 2003 to 2014. Clinical, surgical and pathological features were retrospectively collected and evaluated. RESULTS Seven patients were identified with tunica vaginalis mesothelioma. Average age at the time of diagnosis was 63.6 years. Four patients presented with hydrocele, one with scrotal mass, one with inguinal mass, and one with spermatocele. Two (28.6%) patients reported possible asbestos exposure. Radical orchiectomy was performed in all patients. Two patients received adjuvant radiotherapy, one patient received both chemotherapy and radiation. All patients were followed up postoperatively with serial imaging detect for recurrence. One of 7 patients in our cohort experienced recurrence at 12 months. Our mean follow-up time on these patients is 52.2 months. CONCLUSION Previous reported cases have described poor prognosis of tunica vaginalis mesothelioma despite aggressive surgery and systemic therapy. Our single-institution experience suggests relatively good outcomes with surgery and limited adjuvant therapies. Post treatment surveillance is also imperative and should include imaging routinely within the first 2 years. Negative asbestos exposure screening during history should not eliminate clinical suspicion.