案例報告：玉米粉塵曝露且無其他明顯相關危險因子的睪丸惡性間質瘤
王聆１、康智雄２、宋明澤３
１高雄長庚紀念醫院 外科部; ２高雄長庚紀念醫院 泌尿科; ３高雄長庚紀念醫院 病理部
Case Report: Malignant mesothelioma of tunica vaginalis testis with no obvious associated documented risk factors except exposure to corn powder
Ling Wang1, Chih-Hsiung Kang2; Ming-Tse Sung3
Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Taiwan1; Department of Urology, Kaohsiung Chang Gung Memorial Hospital, Taiwan2; Department of Pathology, Kaohsiung Chang Gung Memorial Hospital, Taiwan3
Introduction: Malignant mesothelioma of tunica vaginalis testis is rarely observed[1, 2]. Most common etiologic factors are asbestos exposure, trauma history and association with hydrocele, but may also occur in the absence of any obvious risk factor[2, 3]. Our patient has right hydrocele without asbestos exposure or trauma history. After right radical orchiectomy, the patient was subsequently diagnosed as malignant mesothelioma of tunica vaginalis by pathology. As there were no evidence of distant metastasis or lymph node invasion, the patient did not receive radiotherapy or chemotherapy and kept routinely follow-up at our Urology outpatient clinic so far so good.
Case Report: A 70-year-old male patient visited our Urology outpatient clinic for right testis swelling and pain. The mass had been noted for about two months without any history of trauma or asbestos exposure. The patient makes living as a corn-powder wholesaler, who has high opportunity exposed to corn-powder dust for years. His medical history was noted for toxic hyperthyroidism under medical treatment and gastric adenocarcinoma stage IIIC status post operation and chemotherapy. Ultrasonography showed right testis moderate heterogenous hypoechogenicity which accumulated by fluid and septation inside, which suspect inflammation, hematoma or tumor. Hemogram level of PSA, CRP, leukocyte was not elevated, and urinalysis showed no pyuria and chest radiography had no abnormality. Antibiotics was then prescribed for about 3 weeks. However, the follow-up ultrasonography 20 days later still showed suspicious of right orchitis with hydrocele formation containing septation. Because of no regression of right testis swelling and tenderness, the patient underwent right orchiectomy.
After right orchiectomy, computed tomography (CT) of the abdomen showed no evidence of distant metastasis or recurrent tumor. Pathology was consistent with the diagnosis of right tunica vaginalis mesothelioma and immunohistochemical stain was performed with a result of positive calretinin and CK-7. The patient is well now and continuously follow-up at our Urology outpatient clinic.
案例報告：玉米粉塵曝露且無其他明顯相關危險因子的睪丸惡性間質瘤
王聆１、康智雄２、宋明澤３
１高雄長庚紀念醫院 外科部; ２高雄長庚紀念醫院 泌尿科; ３高雄長庚紀念醫院 病理部
Case Report: Malignant mesothelioma of tunica vaginalis testis with no obvious associated documented risk factors except exposure to corn powder
Ling Wang1, Chih-Hsiung Kang2; Ming-Tse Sung3
Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Taiwan1; Department of Urology, Kaohsiung Chang Gung Memorial Hospital, Taiwan2; Department of Pathology, Kaohsiung Chang Gung Memorial Hospital, Taiwan3
Introduction: Malignant mesothelioma of tunica vaginalis testis is rarely observed[1, 2]. Most common etiologic factors are asbestos exposure, trauma history and association with hydrocele, but may also occur in the absence of any obvious risk factor[2, 3]. Our patient has right hydrocele without asbestos exposure or trauma history. After right radical orchiectomy, the patient was subsequently diagnosed as malignant mesothelioma of tunica vaginalis by pathology. As there were no evidence of distant metastasis or lymph node invasion, the patient did not receive radiotherapy or chemotherapy and kept routinely follow-up at our Urology outpatient clinic so far so good.
Case Report: A 70-year-old male patient visited our Urology outpatient clinic for right testis swelling and pain. The mass had been noted for about two months without any history of trauma or asbestos exposure. The patient makes living as a corn-powder wholesaler, who has high opportunity exposed to corn-powder dust for years. His medical history was noted for toxic hyperthyroidism under medical treatment and gastric adenocarcinoma stage IIIC status post operation and chemotherapy. Ultrasonography showed right testis moderate heterogenous hypoechogenicity which accumulated by fluid and septation inside, which suspect inflammation, hematoma or tumor. Hemogram level of PSA, CRP, leukocyte was not elevated, and urinalysis showed no pyuria and chest radiography had no abnormality. Antibiotics was then prescribed for about 3 weeks. However, the follow-up ultrasonography 20 days later still showed suspicious of right orchitis with hydrocele formation containing septation. Because of no regression of right testis swelling and tenderness, the patient underwent right orchiectomy.
After right orchiectomy, computed tomography (CT) of the abdomen showed no evidence of distant metastasis or recurrent tumor. Pathology was consistent with the diagnosis of right tunica vaginalis mesothelioma and immunohistochemical stain was performed with a result of positive calretinin and CK-7. The patient is well now and continuously follow-up at our Urology outpatient clinic.