The necessity of a more aggressive initial surgical treatment in patients with mesothelioma of the testicular tunica vaginalis

Publication date: Available online 12 October 2019Source: Annals of Medicine and SurgeryAuthor(s): Clement Brun, Sophie Giusiano, Khady Thiam, Julien Guinde, Marios Froudarakis, Philippe AstoulAbstractMesothelioma of the tunica vaginalis of the testis (MTVM) is a rare tumor encountering for less than 1% of mesothelioma. Patients suffering from these tumors have poor survival due to local and distant metastasis despite treatment. Actually, no specific treatment recommendations exist for this tumor, yet radical orchidectomy is the gold standard in limited disease. We herein report the case of a 71 patient with MTVM who underwent radical orchidectomy without inguinal lymph node dissection and recurred 2 years later with metastasis in pelvic and mediastinal lymph nodes. Despite systemic chemotherapy combining pemetrexed, bevacizumab and Cisplatinum, the disease relapsed eight months later with multiple metastatic lung nodules leading to a treatment shift. We believe that systematic inguinal-iliac lymph node resection should be included in the initial treatment of this tumor.

Source: Annals of Medicine and Surgery - October 12, 2019 Category: General Medicine Source Type: research