Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Laboratory of Cancer Epidemiology, National Cancer Institute, Vilnius, Lithuania.
BMC Cancer. 2020 Feb 27;20(1):162. doi: 10.1186/s12885-020-6648-3.
Malignant mesothelioma of the tunica vaginalis is a rare tumour which comprises less than 1% of all mesotheliomas.
69-years old patient with painful hard mass and hydrocele in the right scrotum to whom a right hydrocelectomy was performed. Any history of scrotal trauma or exposure to asbestos was not present. Excisional biopsy revealed a multinodular tumour with focal areas of necrosis and infiltrative growth. According to morphological and immunohistochemical findings, diagnosis of malignant biphasic mesothelioma of the tunica vaginalis testis was made. Two months after hydrocelectomy, right inguinal orchidectomy was performed. Post-surgical whole body CT scan revealed paraaortic and pararenal lymphadenopathy, likely to be metastatic. Adjuvant treatment with 6 cycles of cisplatin and pemetrexed was applied. After 3 cycles of chemotherapy, CT scan showed progression and the treatment was changed to gemcitabine 1 month after.
Although malignant mesothelioma of the tunica vaginalis is a rare malignancy, it poses a diagnostic challenge which can mimic common inguinal or scrotal diseases such as hydrocele. Despite aggressive surgical procedures or adjuvant therapies, the prognosis remains poor.
鞘膜恶性间皮瘤是一种罕见的肿瘤，占所有间皮瘤的比例不到 1%。
一名 69 岁男性患者，右侧阴囊肿物伴疼痛、质地硬，行右侧睾丸鞘膜切除术。患者无阴囊外伤史或石棉暴露史。切除活检显示为多结节肿瘤，伴局灶性坏死和浸润性生长。根据形态学和免疫组化检查结果，诊断为睾丸鞘膜恶性双相型间皮瘤。睾丸鞘膜切除术 2 个月后，行右侧腹股沟睾丸切除术。术后全身 CT 扫描显示主动脉旁和肾周淋巴结肿大，可能为转移性病变。术后辅助治疗采用顺铂和培美曲塞 6 个周期。化疗 3 个周期后，CT 扫描显示进展，1 个月后改为吉西他滨治疗。
尽管睾丸鞘膜恶性间皮瘤是一种罕见的恶性肿瘤，但它具有诊断挑战性，可能类似于常见的腹股沟或阴囊疾病，如鞘膜积液。尽管采用了积极的手术治疗或辅助治疗，预后仍然较差。
