Busto Martin Luis, Portela Pereira Paula, Sacristan Lista Felipe, Busto Castañon Lusi
Service of Urology, Complexo Hospitalario Universitario da Coruña, La Coruña, Spain.
Arch Esp Urol. 2013 May;66(4):384-8.
To report a case of a mesothelioma of the tunica vaginalis and to review the published literature. METHODS / RESULTS: A 61-year-old patient complained of one-month increase of right scrotum size with pain. An ultrasound showed a right hydrocele with a mass attached to the tunica vaginalis. He didn't refer any urological history or known exposure to asbestos. Blood levels of tumor markers (alpha-fetoprotein and beta-HCG) were within normal limits. We performed a radical inguinal orchiectomy with an en-bloc resection of the tunica vaginalis. The pathology described a potentially malignant biphasic mesothelioma. The patient has remained asymptomatic with negative extension studies after 10 years of follow up.
Paratesticular mesotheliomas are rare tumors (approximately 250 cases reported )with uncertain etiology (only 30-40% are associated with asbestos exposure). The age range is between 50-70 years. Its presentation is usually as a scrotal mass with recurrent reactive hydrocele, which may delay early diagnosis. During surgery, intraoperative biopsy is recommended. It is important to do a differential diagnosis with other benign diseases. Treatment is only curative in early stages with radical orchidectomy and resection in-block of the tunica vaginalis. Despite being multidisciplinary, it is not curative in most cases due to rapid local and distant spread.
报告一例睾丸鞘膜间皮瘤病例并复习已发表的文献。方法/结果：一名61岁患者主诉右侧阴囊增大伴疼痛1个月。超声检查显示右侧鞘膜积液，有一肿物附着于睾丸鞘膜。他无任何泌尿系统病史，也无已知的石棉接触史。肿瘤标志物（甲胎蛋白和β-人绒毛膜促性腺激素）血水平在正常范围内。我们进行了根治性腹股沟睾丸切除术，并整块切除睾丸鞘膜。病理检查显示为潜在恶性的双向性间皮瘤。经过10年随访，患者一直无症状，扩展检查结果为阴性。
睾丸旁间皮瘤是罕见肿瘤（报道约250例），病因不明（仅30%-40%与石棉接触有关）。发病年龄在50至70岁之间。其表现通常为阴囊肿物伴反复反应性鞘膜积液，这可能会延迟早期诊断。手术期间，建议进行术中活检。与其他良性疾病进行鉴别诊断很重要。早期通过根治性睾丸切除术和整块切除睾丸鞘膜进行治疗可能治愈。尽管采用多学科治疗，但由于局部和远处迅速扩散，大多数病例无法治愈。
