Journal Article

Imaging of mesothelioma of tunica vaginalis testis

Grenier, N., Oltmanns, G., Dudea, S. M., Valentino, M., Bertolotto, M., Stein, M. W., Boulay-Coletta, I., Derchi, Lorenzo E., Butini, R., Ramchandani, P.

2016

Overview

Objectives To describe the imaging findings in a series of patients with mesothelioma of the tunica vaginalis testis. Methods We reviewed clinical data, imaging findings and follow-up information in a series of 10 pathology-proven cases of mesothelioma (all had US; 2 had MR) of the tunica vaginalis. Results A variety of patterns could be observed, the most common (5/10) being a hydrocele with parietal, solid and hypervascular vegetations; one patient had a septated hydrocele with hypervascular walls; one had multiple, solid nodules surrounded by a small, physiological quantity of fluid; one a cystic lesion with thick walls and vegetations compressing the testis; two had a solid paratesticular mass. MR showed multiple small nodules on the surface of the tunica vaginalis in one case and diffuse thickening and vegetations in the other one; lesions had low signal intensity on T2-w images and were hypervascular after contrast injection. Conclusions A preoperative diagnosis of mesotheliomas presenting as solid paratesticular masses seems very difficult with imaging. On the contrary, the diagnosis must be considered in patients in whom a hydrocele with parietal vegetations is detected, especially if these show high vascularity. Key Points • Mesotheliomas of the tunica vaginalis are rare, often challenging to diagnose preoperatively . • Most common finding is a complex hydrocele with hypervascular parietal vegetations . • Septated hydrocele, nodules without hydrocele, a thick-walled paratesticular cyst are less common . • Preoperative diagnosis may allow aggressive surgical approach and, possibly, a better prognosis .

• Publisher: Springer Berlin Heidelberg,Springer Nature B.V
• Subject: Adult / Aged / Aged, 80 and over / Contrast Media / Diagnosis, Differential / Diagnostic Radiology / Follow-Up Studies / Hospitals / Humans / Imaging / Internal Medicine / Interventional Radiology / Magnetic Resonance Imaging - methods / Male / Medicine / Medicine & Public Health / Mesothelioma / Mesothelioma - blood supply / Mesothelioma - diagnosis / Mesothelioma - diagnostic imaging / Middle Aged / Neuroradiology / Radiology / Retrospective Studies / Survival Rate / Testicular Hydrocele - diagnosis / Testicular Hydrocele - diagnostic imaging / Testicular Neoplasms - blood supply / Testicular Neoplasms - diagnosis / Testicular Neoplasms - diagnostic imaging / Treatment Outcome / Ultrasonography, Doppler, Color - methods / Ultrasound / Urogenital