Imaging of mesothelioma of tunica vaginalis testis

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

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14 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)631-638
Number of pages8
JournalEuropean Radiology
Volume26
Issue number3
DOIs
StatePublished - Mar 1 2016

Keywords

  • Magnetic resonance imaging
  • Mesothelioma
  • Preoperative diagnosis
  • Tunica vaginalis testis
  • Ultrasound

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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    Bertolotto, M., Boulay-Coletta, I., Butini, R., Dudea, S. M., Grenier, N., Oltmanns, G., Ramchandani, P., Stein, M. W., Valentino, M., & Derchi, L. E. (2016). Imaging of mesothelioma of tunica vaginalis testis. European Radiology, 26(3), 631-638. https://doi.org/10.1007/s00330-015-3887-9