da Fonseca Leonardo Gomes, Marques Daniel Fernandes, Takahashi Tiago Kenji, Aguiar Fernando Nalesso, Ravanini Juliana Naves, Saragiotto Daniel Fernandes
Department of Oncology - Instituto do Câncer do Estado de São Paulo, São Paulo/SP - Brazil.
Department of Pathology - Instituto do Câncer do Estado de São Paulo, São Paulo/SP - Brazil.
Autops Case Rep. 2014 Mar 31;4(1):45-51. doi: 10.4322/acr.2014.007. eCollection 2014 Jan-Mar.
Mesothelioma of the tunica vaginalis testis (MTVT) is a rare tumor that usually affects patients after the sixth decade of life. Exposure to asbestos is a known risk factor. Enlargement of the scrotal volume is the most common initial clinical manifestation, and about 15% of cases present metastasis at diagnosis. The treatment relies on surgical resection while the role of adjuvant chemotherapy and radiotherapy remains unclear. The prognosis for patients is generally poor, with a lethal outcome in 30% over a 24-month period. The authors report a case of a 62-year-old patient with the diagnosis of MTVT without a history of asbestos exposure. After surgical treatment, metastatic disease ensued. Chemotherapy was initiated, but could not be continued due to marked and fast clinical deterioration. The authors call attention to the difficulty of early diagnosis of MTVT due to a nonspecific clinical picture, the lack of action by the patient when the scrotal enlargement was first noticed, and the lack of tumor markers. Delayed diagnosis is definitely related to unfavorable prognosis.
睾丸鞘膜间皮瘤（MTVT）是一种罕见肿瘤，通常影响60岁以后的患者。接触石棉是已知的风险因素。阴囊体积增大是最常见的初始临床表现，约15%的病例在诊断时出现转移。治疗依赖于手术切除，而辅助化疗和放疗的作用仍不明确。患者的预后通常较差，24个月内30%会出现致命结局。作者报告了一例62岁诊断为MTVT的患者，该患者无石棉接触史。手术治疗后，出现了转移性疾病。开始进行化疗，但由于明显且迅速的临床恶化而无法继续。作者提醒注意，由于临床表现不具特异性、患者首次注意到阴囊增大时未采取行动以及缺乏肿瘤标志物，MTVT早期诊断存在困难。延迟诊断肯定与不良预后相关。
