Testicular mesothelioma is the rarest type of this cancer and accounts for .3% to 5% of all diagnosed cases reported. Because of how rare it is, there is little research on the subject, making it difficult to diagnose and treat. Unlike other types, research that mentions testicular mesothelioma tends to only describe the disease rather than provide insight on how to diagnosis, treat or prevent it.
Testicular mesothelioma affects the lining of the testicles. This lining is known specifically as the tunica vaginalis and tunica albuginea. From this point of origin, cancerous tumors can spread to the rest of the body if left untreated. The tunica vaginalis covers the testis like a sac. It is comprised of two layers, the parietal and visceral. The parietal layer lines the cavity of the scrotum while the visceral layer overlies the tunica albuginea. Between the two sections is a small space that is filled with lubricating fluid, reducing the friction that arises from movement between the testes and scrotum.
What is the tunica albuginea?
The tunica albuginea, or “white coat” in Latin, is a lining of dense tissue that envelopes the testes, connecting to the fibres that surround the ducts that move sperm out of the penis from the testes (epididymis). In addition to serving as a protective layer, the tunica albuginea also helps maintain erection of penis or clitoris by trapping blood in erectile tissue.
How is testicular mesothelioma caused?
While asbestos may cause some cases, there hasn’t been research proving this for sure. In addition, scientists aren’t sure how asbestos fibers are able to reach the testicles. However, risk factors that are related to general cancer of the testicles may also relate to testicular mesothelioma. These factors include age, cryptorchidism (one testicle isn’t located in its proper position at birth), trauma and profession. It is believed that miners, firefighters, plumbers and individuals who’ve worked in the printing, leather and gas industries may be at a higher risk because of exposure to certain dyes and solvents.
Testicular mesothelioma can also be the result of mesothelioma that first develops in another area of the body, usually the abdomen (peritoneal). This is because the tunica vaginalis is actually peritoneal tissue.
How do you diagnose peritoneal mesothelioma?
Biopsy is usually the only way to diagnose testicular mesothelioma accurately. The tissue or fluid sample is examined microscopically for the presence of cancer cells. Biopsy is usually performed after physical examination, review of medical history, and possibly imaging scans such as an ultrasound.
Symptoms of testicular mesothelioma are often confused with other diseases affecting the testicles. Symptoms include:
- pain in the testicles that may radiate out to the thighs and lower back
- swelling of the testicles
- a lumpy appearance
- weight loss
- nausea and vomiting
Treatments for testicular mesothelioma are generally the same for other types. Surgery (which involves removing a portion or all of the testicles),radiation therapy and chemotherapy are commonly prescribed. The latter two are advised when the cancer has spread and may be for palliative purposes only. Surgery, however, may not be possible if the patient is at a later stage. Life expectancy after being diagnosed with testicular mesothelioma is within two years2.