Malignant mesothelioma of the tunica vaginalis testis: A case with a predominant sarcomatous component

Abstract

We present a case of malignant mesothelioma (MM) of the tunica vaginalis testis. A 64-year-old man was referred for an operation on a right hydrocele that later proved to be a tumor during surgery. The tumor was malignant with a biphasic pattern of epithelial and sarcomatous components. The latter component was predominant. Cuboidal or columnar cells formed irregular tubular structures in the epithelial component. In contrast, spindle-shaped or polygonal cells formed intricate structures with stromal connective tissues in the sarcomatous component. Immunohistochemical staining revealed that the tumor was mesothelial in origin and positive for cytokeratin, vimentin, HBME-1 antigen and calretinin. In general, MM occur in the pleura or peritoneum; those originating in the tunica vaginalis testis are very rare and represent less than 5% of all MM. In addition, MM in the tissues usually consist primarily of an epithelial component. According to previous reports tumors with a predominant sarcomatous component are extremely rare. In general, a sarcomatous component predicts poor prognosis and our case does, in fact, deteriorate over time. Our case suggests that despite its low incidence, MM must be considered when a case is diagnosed as hydrocele testicle.

Malignant Mesothelioma of the Tunica Vaginalis Testis in a Dog: Histological and Immunohistochemical Characterization

“…These findings strongly suggest that canine MM of the tunica vaginalis testis shares immunophenotypic characteristics with a similar neoplasm reported in human beings. 10 Although the outcome of MM of the tunica vaginalis testis is not known for every reported case in human beings, the overall clinical prognosis for mesothelioma is poor, 4 and, as such, radical orchiectomy should be the first-line therapy. 11 The efficacy of adjuvant chemotherapy and radiotherapy has not yet been clearly determined.…”

Malignant Mesothelioma of the Tunica Vaginalis Testis

“…1,13 Pure sarcomatous mesothelioma is exceedingly rare. 14 The differential diagnosis of paratesticular mesothelioma includes both benign and malignant conditions. Mesothelial hyperplasia, welldifferentiated papillary mesothelioma, papillary serous neoplasms, rete and epididymal carcinoma, adenomatoid tumors, and adenocarcinoma may exhibit similar morphologic characteristics and may mimic malignant mesothelioma.…”

Testicular Mesothelioma

“…Among the most frequent histological variants of mesothelioma is epithelioid (50-70%) as a set of buds with delicate gripping growths covered with prismatic, cubic or polygonal cells with pale vacuolated cytoplasm and with evidence of cellular polymorphism, hyperchromatosis of the nuclei, the www.intechopen.com presence of pathological mitoses and giant cells, as if spun from each other, that is, in our opinion, the pathognomonic morphological sign of mesothelioma, and for which can not be wrong [115]. The other type is sarcomatoid which is much more serious than the epithelioid, and it affects the secondary tissues including the bone, muscles, cartilage or fat [94]. This type of cancer cell is a much more rare type that occurs in 7-20% of the cases.…”