Testicular Mesothelioma

Testicular mesothelioma is a cancer of the membrane lining that covers the testicle. Also called mesothelioma of the tunica vaginalis testis, this rare disease accounts for less than 1 percent of all mesothelioma cases.

In addition, the disease puzzles researchers, because typical mesothelioma patients can trace their disease to the inhalation or ingestion of asbestos dust or fibers while most testicular cancer patients have no history of asbestos exposure.
There is a scarcity of research about the testicular type because it is so rare. Despite that, men with this type of cancer enjoy a significantly better prognosis than most people with other forms of mesothelioma cancer. Most studies found median survivals of about 20 to 23 months, and one patient lived 15 years after diagnosis.

Symptoms and Diagnosis

Due to the rarity of this disease, there is no recognized set of symptoms for testicular mesothelioma cancer. The cancer is often mistaken for more common ailments such as a hernia, so many testicular mesothelioma patients initially receive a wrong diagnosis. Typically, testicular mesothelioma is only properly diagnosed during surgery.
The most common symptom is a hydrocele, a buildup of fluid in the scrotum. Men may notice a swollen testicle.

Treatment

Testicular mesothelioma treatment typically involves removal of a portion of one testicle, or even an entire testicle if necessary, depending on the extent of the cancer.
Treatment for testicular mesothelioma often involves surgery which may include aspiration, hydrocelectomy, inguinal orchiectomy, hemiscrotectomy and lymphadenectomy. Treatment may be followed by chemotherapy or radiation therapy to kill any remaining cancer cells.
Because this type of cancer is often a secondary tumor, with the primary tumor located within the peritoneum (the membrane lining the abdominal cavity), treatment may not be as simple as removing testicular tumors. In these cases, the primary tumors must be treated as well.

It should be noted that both peritoneal and testicular mesothelioma are classified as being clinically aggressive types of cancer. This means they can spread rapidly. In addition, the testicular type tends to recur within a few years, even in cases where tumors are surgically removed.

Asbestos and Testicular Mesothelioma

Because this type of cancer is extremely rare, very little is known about how it develops. Most researchers theorize there are two possible points of origin for testicular mesothelioma. The tunica vaginalis, the membrane where the cancer develops, is composed of mesothelial cells, which are present in most of the body's membranous linings. The tunica vaginalis is made up of two layers, known as the parietal (outer) and visceral (inner) layers.
Firm white-yellow nodules can be found on the serosal surface of the tunica. The nodules can eventually encase the contents of the scrotum, and cause the tunica vaginalis to thicken.
While there is currently no theory to explain how asbestos exposure might cause a primary tumor to develop in the testicles, it is understood that once the asbestos fibers are in the body, they can become lodged in organs and cause inflammation or infection that can result in the development of mesothelioma. The fibers cause cancerous cells to divide abnormally, causing buildup of fluid and the development of tumors.
Once cells have become cancerous, they are no longer able to regulate their own cycles of growth and division. A primary tumor that develops in the testicle is formed from cancerous cells that divide without restraint, which causes the thickening of the tunica vaginalis and can eventually lead to the formation of tumors.