The testicular mesothelioma develops in the testes of the tunica vaginalis, the membrane that lines the testes. This is the rarest of the four main types of mesothelioma, accounting for less than 1% of all mesothelioma diagnoses, with only about 100 cases reported.
The testicular mesothelioma or malignant mesothelioma of the tunica vaginalis lacks considerable research due to a limited number of cases. Unlike the other forms of mesothelioma, the cause of this type is unclear. 41% of the reported cases have been linked to asbestos exposure studies. In other cases, the researchers find that past trauma, prolonged groin development or previous hernia repair may lead to a diagnosis of testicular mesothelioma. Due to their rarity, the course of the disease and life expectancy is still unclear.
The testicular mesothelioma is a cancer of the membrane that lines the testes. This is a rare disease, also known as mesothelioma of the tunica vaginalis testis, accounts for less than 1 percent of all mesothelioma cases. This diagnosis confuses researchers because most people with mesothelioma can attribute their illness to inhalation or ingestion of asbestos dust.
What Is The Prognosis For Testicular Mesothelioma?
The testicular mesothelioma has generally shown a better prognosis than other forms of the disease since it is localized and several documented cases of mesothelioma of the tunica vaginalis were benign. Researchers have found that median survival is typically 20 to 23 months, although some patients lived years after diagnosis. This is better than the other forms of mesothelioma with a life expectancy of only about one year to 21 months.
Several factors can influence the prognosis of a single patient, including:
- Cell type
- Tumor size and staging
- Gender and age of the patient
As with other types of mesotheliomas, cancer cells show an aggressive growth rate and can rapidly metastasize. In addition, there is a high risk of the recurrence. One study found a recurrence rate of at least 53%, with at least 60% occurring within two years of successful treatment. In patients with recurrent testicular mesothelioma, research indicates an average life expectancy of about 14 months.
Testicular Mesothelioma Symptoms
Similar to pleural mesothelioma and peritoneal mesothelioma, most patients with the mesothelioma testicular exhibit nonspecific symptoms that are easily due to other conditions and conditions such as inguinal hernias or other testicular cancers. Doctors have also seen asymptomatic cases where the diagnosis comes from a routine physical examination.
Sometimes testicular mesothelioma tumors are secondary in nature and in some cases associated with peritoneal mesothelioma metastases. In these cases, patients may experience more symptoms that affect the abdomen, such as abdominal pain or swelling. The researchers also found that some of the common symptoms, such as prolonged hydrocele, may also lead to a diagnosis of testicular mesothelioma.
Common Symptoms Of Testicular Mesothelioma
- A knot or a mass on the testicle
- Hydrocele (accumulation of fluid in the scrotum that causes swelling)
- Pain in the testicles
- Inflammation of the epididymis (epididymitis)
Next, the doctor will order an ultrasound, the type of imaging scan that is 90 percent accurate for detecting testicular tumors. When a potential tumor is detected, other imaging scans can be performed to determine the tumor stage and to determine if cancer has spread.
To confirm that the tumor is testicular mesothelioma, physicians can take a blood sample and search for mesothelioma tumor markers. These are substances that are released by mesothelioma tumors and confirm a diagnosis.
Testicular Mesothelioma Facts
- May cause pain, swelling or fluid retention in the testes
- During surgery, the affected testes and spermatic cord are removed
- Other treatments include chemo and radiotherapy
- Maybe related to occupational asbestos exposure
Because of the limited number of known cases, men with this type of cancer have a significantly better prognosis than most people with other types of mesothelioma. Most studies report a median survival of about 20 to 23 months, and one patient lived 15 years after diagnosis.
How Is Testicular Mesothelioma Diagnosed?
After a patient has symptoms or testicular irregularity is detected during the examination, the doctor will schedule an imaging exam, probably an ultrasound. Testicular mesothelioma ultrasound is a non-invasive, low-risk procedure that uses sound waves to create an image of the scrotum. The ultrasound may have to swell such as hydrogels or masses that have developed. Studies have shown that about 56% of the testes mesothelioma patients show hydrocele, while about 33% in the testes have some solid mass.
After an ultrasound scan, a doctor will likely perform a blood test or an assay to determine the cause of the symptoms and possibly detect cancer early. Specifically for mesothelioma, there are a number of biomarkers in the blood that doctors can use to detect asbestos cancer at an early stage, including calretinin, cytokeratin 5/6 and Wilms' tumor 1 (WT1), which are commonly expressed by mesothelioma tumors.
Although a blood test may indicate a mesothelioma diagnosis, the only definitive way to diagnose the cancer is tissue biopsy. The biopsy is usually the last step in the diagnostic process and determines cell type and staging. This then gives an insight into the prognosis of a patient. Additional tests may be performed to better determine the metastasis of lymph nodes or other body parts and secondary tumors.
Testicular Mesothelioma Stages
The understanding the stage of cancer is an important aspect in determining a patient's prognosis and developing an appropriate treatment plan. Because this form of mesothelioma is so rare, physicians do not have enough data to develop a suitable staging system. Instead, physicians use general mesothelioma features to determine how advanced the case of a patient is and how it can be expected to progress.
Stage 1 or 2 testicular mesothelioma indicates a localized tumor. With limited or no cancer growth, more treatment options are available to patients, e.g. As cancer progresses and spreads to the lymph nodes and other organs, the treatment options are more limited and the prognosis worsens.
Testicular Mesothelioma Treatment
Testicular mesothelioma was most often treated with a multimodal approach combining surgery, chemotherapy, and radiotherapy. Whether aggressive mesothelioma treatment is or will not be performed will depend largely on whether the disease is still localized or metastasized. The treatment options are limited when the cancer is more advanced.
Researchers have found that optimal treatment for localized diseases consists of a radical inguinal orchiectomy. A surgical procedure in which one or both testes and the spermatic cord are removed. This operation is considered standard for the treatment of all testicular carcinomas, although some options for testicular savings are available for some patients. Since studies have shown that testicular mesothelioma often affects only one testicle when localized, less aggressive surgery may be an option for some patients. However, one study found that the recurrence rate among patients who opted for a more radical operation dropped by nearly 25%.
After surgery, chemotherapy with cisplatin and pemetrexed may follow. Doctors may offer radiation therapy to kill remaining cancer cells and prevent cancer from returning. If the cancer is diagnosed early, chemotherapy and radiotherapy may not be required after surgery.
Chemotherapy alone or in combination with radiotherapy is another option for patients with advanced disease. Which can sometimes be used in combination with surgery. As it is so rare, researchers are not sure about the best chemotherapy options for testicular mesothelioma. In the documented case reports, most patients were treated with the standard of care, Alimta and cisplatin. Chemotherapy in combination with radiation may also be a good option for patients experiencing recurrent testicular mesothelioma. Ultimately, patients need to seek professional medical advice for their particular case.
Asbestos And Testes Mesothelioma
When microscopic asbestos fibers enter the body. They can lodge in the lining of organs and cause inflammation and genetic damage to the cells. This can eventually lead to the development of mesothelioma because cancer cells divide abnormally. Resulting in fluid accumulation and the formation of tumors.
The membrane of the testes is called the tunica vaginalis. Mesothelioma appears on the surface of the tunica vaginalis as a firm white-yellow knot. And the knots can enclose the contents of the scrotum and cause the tunica vaginalis to thicken.
Mesotheliomas usually develop in the lining of the lungs or abdomen because asbestos fibers are inhaled or swallowed. Testicular mesothelioma is extremely rare. And physicians still do not understand how exposure to asbestos can cause a primary tumor to develop in the testes.
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