Testicular Mesothelioma
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Share ArticleMesothelioma is a type of cancer that affects the mesothelium lining of the body. The mesothelium is composed of mesothelial cells that form a layer covering the abdominal cavity, chest cavity, and most internal organs. This layer manufactures a fluid that bathes and protects internal organs and allows for movement. The mesothelium of the chest cavity is referred to as the pleura, and the mesothelium of the abdominal cavity is referred to as the peritoneum.
Mesothelioma tumors can be malignant or benign. The most common type of malignant mesothelioma is pleural mesothelioma, which affects the chest cavity. This accounts for 75% of mesothelioma cases. The rarest type of mesothelioma is testicular mesothelioma, which occurs on the tunica vaginalis. The tunica vaginalis is the mesothelium lining that shields the testicles by pouching out from the peritoneum in a double layer. Although there are 2,000 to 3,000 cases of malignant mesothelioma diagnosed yearly, there have been fewer than a hundred reported cases overall of testicular mesothelioma. Malignant mesothelioma occurs mostly in people over the age of 55, and three-fourths of mesothelioma diagnoses occur in people over the age of 65. Testicular mesotheliomas occur in a wide age range, from children to elderly men, though most cases occur at an average of fifty years of age. Mesothelioma is more prevalent in the Caucasian population, specifically the blue-collar segment of the population, which is most likely due to the asbestos risk factor.
The major risk factor for developing malignant mesothelioma is exposure to asbestos. Asbestos is insulation made from magnesium-silicate mineral fibers. Asbestos was preferred as a construction material because the fibers resist melting and burning, and the fibers are also inefficient at conducting heat. When adverse health effects began to emerge in people who had experienced extensive contact with asbestos, it dropped out of favor as a construction material. Many developed countries have banned the use of asbestos as a building material. Asbestos is not currently banned in the United States, though it is not used as frequently as in earlier decades. Even though asbestos is not preferred as a construction material, residual asbestos is still present in schools, buildings, and homes that were constructed in the earlier part of the century.
Asbestos is also a naturally occurring substance in the environment, so exposure to asbestos is not solely a result of coming into contact with older building materials. Other places where asbestos can be found are shipyards, mines, manufacturing facilities, in brake pads, and duct insulation. Blue-collar workers and US Navy veterans are most likely to be exposed to asbestos as an occupational hazard, and second-hand exposure in their families and friends can occur from the fibers that these workers carry on their clothing.
Most occurrences of mesothelioma can be linked to asbestos exposure in some form. The body is unable to clear asbestos from the system, so any exposure to asbestos is permanent. Other risk factors for developing mesothelioma include tobacco, exposure to radiation, zeolite, and possibly exposure to simian virus 40. When tobacco use is combined with asbestos exposure, the risk of developing mesothelioma skyrockets to as much as fifty to ninety percent.
Often the only symptom of testicular mesothelioma is a lump in the testicles. Because the symptoms of mesothelioma are so easily attributable to a variety of diseases, cancer may not be immediately diagnosed. This can lead to the mesothelioma being in an advanced stage of disease before it is diagnosed and treated. Unfortunately, malignant mesothelioma is an aggressive form of cancer. The average survival rate after a mesothelioma diagnosis is one year, and the five-year survival rate is around 10 percent. Because asbestos is no longer commonly used in building materials, doctors expect the rate of diagnosis of mesothelioma to remain stable, instead of increasing further.
Testicular mesothelioma is an extremely rare cancer. More common testicular cancers include nonseminomas germ cell, seminomas germ cell or non-germ cell. Most frequently it is found as a palpable tumor, but it is also sometimes found during hernia repair. This finding can be associated with hydrocele, which is a fluid-filled sac surrounding the testicle, with or without a detectable mass. Testicular mesotheliomas are aggressive, and have a tendency to recur within two years, spreading to other areas such as nearby organs, lymph nodes, chest cavity, lungs, and the brain. Most patients die two years after their diagnosis.
Malignant mesothelioma is difficult to treat, because it is not a centralized tumor mass. Mesothelioma tends to spread along nerves, blood vessels, and surfaces. Because of this tendency to spread, multiple methods of treatment must be employed to fight the cancer, and treatment is often unsuccessful if the cancer is in a later stage. If malignant mesothelioma is diagnosed in Stage I of the disease, surgery is often used to remove tumor masses. The use of chemotherapy and radiation after surgery is still being studied to determine a good course of action for mesothelioma treatment. Radiation alone may be used if the person’s health is unable to withstand major surgery. In Stages II and III, symptom relief is stressed because mesothelioma is often incurable at this level of development of the cancer. Surgery to remove as much of the cancer as possible is employed, as well as some chemotherapy and radiation. Enrollment in clinical trials is recommended to take advantage of the latest developments in mesothelioma treatments. In Stage IV, malignant mesothelioma spreads to organs distant from the original site of disease and becomes impossible to cure. Supportive care or hospice care are usually the best options for treatment.
- American Cancer Society, "What Is Malignant Mesothelioma?"
Accessed: March 6th 2008. - Early, Ludwick, Sweeney & Strauss, "Mesothelioma Risk Factors", http://www.mesothelioma.com/mesotheliomainfo_risks.htm
Accessed: March 6th 2008. - "Extrathoracic Mesothelial Proliferations and Their Mimics", http://sup.ultrakohl.com/Uscap/uscap05/meso3.htm, Josep Lloreta-Trull, Department of Pathology,
Accessed: March 6th 2008.
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