Testicular Mesothelioma Causes
Doctors do not yet understand how asbestos exposure can cause a primary tumor to develop on the tunica vaginalis. This is the pouch of the serous membrane that covers the testes. Unlike pleural or peritoneal mesothelioma, this type can not easily be traced to asbestos exposure.
It appears as firm, white-yellow nodules on the surface of the tunica vaginalis. The nodules can eventually encase the contents of the scrotum and cause the membrane to thicken.
Local trauma and inflammation also may play a role in its development. Some cases present without any identifiable risk factors.
Prognosis and Survival Rate for Testicular Mesothelioma
Nearly 49% of patients survive five years after diagnosis, and 33% survive 10 years, according to a 2019 study published in the journal Urology.
Patients with the biphasic cell type had worse overall survival than other types.
Of the 113 testicular mesothelioma patients in the study, 75% of cases had the epithelioid cell type. Older patients and those with tumors greater than or equal to 4 centimeters in size were associated with a worse survival rate.
Testicular Mesothelioma Symptoms and Diagnosis
The most common testicular mesothelioma symptom is a hydrocele, a fluid buildup in the scrotum. There is no set of symptoms unique to testicular mesothelioma cancer.
Many people with this cancer initially receive the wrong diagnosis. This is because doctors often mistake it for a more common condition, such as a hernia.
More than half of the patients in the 2019 Urology study had a hydrocele. About one-third of patients had a painless scrotal mass.
This type is rare and doesn’t present unique symptoms. Testicular mesothelioma is often diagnosed during or after surgery.
The definitive way of confirming a cancer diagnosis is to perform a biopsy. This involves removing a tissue sample from the tumor and sending it to the lab for testing.
Evaluating the sample with immunohistochemical staining helps doctors determine if the patient has testicular mesothelioma or another disease.
Treatment for Testicular Mesothelioma
The most common treatment for testicular mesothelioma is surgery. Nearly all the 113 testicular mesothelioma patients (98.2%) in the 2019 study underwent surgical resection of the tumor.
This procedure removes the affected testicle and the entire spermatic chord. If cancer has spread to nearby lymph nodes, doctors will remove them with a lymphadenectomy surgery.
A 2021 research study noted that testicular mesothelioma requires extensive resection, including metastatic surgery, if complete resection is possible. The study suggested a multimodality treatment plan for the malignancy, similar to a multimodal approach to pleural mesothelioma, offers the best patient outcomes.
Surgery may be followed by chemotherapy with cisplatin and pemetrexed, the longstanding standard-of-care treatment for mesothelioma. Doctors may offer radiation therapy next to kill any remaining cancer cells and prevent cancer from returning.
Only 5.3% of patients received radiation therapy in the 2019 study. Given such a small cohort, researchers could not determine if adjuvant therapy impacts overall survival.
In some cases, testicular mesothelioma is a secondary tumor, with the primary tumor located within the peritoneum (the membrane that lines the abdominal cavity). For situations like this, doctors must treat the patient for peritoneal mesothelioma.