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Testicular mesothelioma is an extremely rare form of mesothelioma associated with asbestos exposure that develops in the tissue lining the testicles. With so few cases, information is limited, but symptoms generally include a lump and fluid buildup. Treatment is straightforward, and the prognosis is better than for other forms of mesothelioma.
Facts About Testicular Mesothelioma
- This type of mesothelioma is so rare that there are only about 100 cases that have been diagnosed and reported ever.
- Most men who develop testicular mesothelioma are over 45, but they can be any age, even as young as in their 20s.
- About half of the known cases have been connected to asbestos. Still, the connection is not as strong as in pleural or peritoneal mesothelioma, the more common types of this cancer.
- Like other types of mesothelioma, the testicular form involves a primary tumor of the mesothelium. This is the thin, double-layered tissue that surrounds many of the organs in the body.
- The mesothelium surrounding the testicles is called the tunica vaginalis, and cancer of this tissue is mesothelioma of the tunica vaginalis or testicular mesothelioma.
- A primary symptom of testicular mesothelioma is a hydrocele, swelling in the scrotum due to a buildup of fluid.
- Nearly half of all patients with testicular mesothelioma survive five years after a diagnosis.
Does Asbestos Exposure Cause Testicular Mesothelioma?
The causes of this type of mesothelioma are primarily a mystery. There is a connection to asbestos, but not everyone who develops this type of cancer has been exposed.
A case study from 2015 describes a 4-year-old patient with testicular mesothelioma and no known risk factors. He had never experienced asbestos exposure to his knowledge.
With the most common type of mesothelioma, the pleural form, inhaled fibers of asbestos become lodged in the lining of the lungs. This causes damage that may lead to cancer.
It seems possible that asbestos that is inhaled, or even accidentally ingested, could move to the testes and cause damage but how is not well understood. For patients never exposed to asbestos, the cause remains unknown.
Testicular Mesothelioma Symptoms
Because there are so few cases, it has been difficult to list common symptoms of testicular mesothelioma. The most likely sign that ultimately leads to a diagnosis is a lump on one of the testicles.
Another common symptom is a hydrocele, which is the buildup of fluid in the tunica vaginalis that causes the scrotum to swell. Most people with this type of mesothelioma end up seeing their doctor for a diagnosis because a lump and a hydrocele can both cause swelling and pain in the testicles.
One case study found that epididymitis, the inflammation of the sperm-carrying tube in the testicles, could be a symptom or complication of testicular mesothelioma.
Diagnosing Testicular Mesothelioma
Because testicular mesothelioma is so rare, the usual first diagnosis is an inguinal hernia. This occurs when the abdominal wall weakens and part of the intestines bulge outward. It can protrude through the testicle causing a lump.
If doctors rule out a hernia, the next step is likely an ultrasound or a CT scan to image the testicles. These are typical imaging techniques used to look for tumors and see if cancer has spread to other organs. Signs of testicular mesothelioma on imaging scans include:
- A singular unusual mass
- Multiple masses
- Diffuse, or widespread lesions
- Overgrowths of the tunica vaginalis
If the images show any of these unusual growths, the doctor performs a biopsy to look at cells from the tumor under a microscope. This can help determine whether the tumors are mesothelioma or another type of cancer, but it is not foolproof. In many cases, the tumor is removed before the diagnosis of mesothelioma comes.
Treatment Options for Testicular Mesothelioma
The most common type of treatment for testicular mesothelioma is to remove part or all of a testicle. This surgery is called an orchiectomy. A radical or complete orchiectomy is the most likely strategy to attempt to cure this type of cancer.
The removal of an entire testicle, if done before cancer has had a chance to spread, could save a patient’s life. Removing the whole testicle is likely because mesotheliomas of all types are aggressive and prone to spread to other organs.
Patients undergoing this surgery are also likely to be imaged to see if the cancer has spread to the nearby lymph nodes. If it has, those may be surgically removed as well.
Imaging scans can then be used as a follow-up after surgery to determine if any cancer is left or has returned months or years after treatment.
Some patients may also receive chemotherapy or radiation therapy as a follow-up to surgery to eliminate any remaining cancerous tissue. With so few cases of this type of cancer, experts cannot say if these adjuvant therapies improve the survival rate.
What Is the Prognosis for Testicular Mesothelioma?
The outlook for someone with a testicular mesothelioma diagnosis is often much better than for other forms of this cancer. It is still an aggressive type of cancer that has the potential to metastasize.
Published in 2019, a survey of 113 known cases of testicular mesothelioma showed higher survival rates than in other types of mesothelioma:
- The five-year survival rate for these patients was 49%, meaning nearly half of all patients were still alive five years after their diagnosis
- The ten-year survival rate was 33%.
- When considering fatalities caused by the cancer, the ten-year survival rate was even higher, at 45%.
- Shorter survival times were associated with older patients and those with larger tumors.
Surgery for testicular mesothelioma is often more successful than with other types of mesothelioma, and some patients go into remission. Even when surgery seems to cure this cancer, though, it may recur. It is always possible, though, that radiation and chemotherapy after surgery reduce that risk.
If you have been diagnosed with mesothelioma and suspect that exposure to asbestos at work was a factor, you have a right to seek compensation through a lawsuit or a mesothelioma trust fund. Let an experienced lawyer look over your case and help you take the next step.Get Your FREE Mesothelioma Packet
Page Medically Reviewed and Edited by Anne Courtney, AOCNP, DNP
Anne Courtney has a Doctor of Nursing Practice degree and is an Advanced Oncology Certified Nurse Practitioner. She has years of oncology experience working with patients with malignant mesothelioma, as well as other types of cancer. Dr. Courtney currently works at University of Texas LIVESTRONG Cancer Institutes.