Mesothelioma is a rare disease, with two or three thousand new cases diagnosed each year in the United States. Testicular mesothelioma is even rarer, with under a hundred verified cases diagnosed in all of medical history. This uncommon form of mesothelioma, however, is still dangerous and like all forms of mesothelioma needs aggressive and immediate treatment.
Testicular mesothelioma develops in the mesothelium, a thin layer of cells that surrounds and protects many areas of the body, such as the lung cavity (pleural mesothelioma), the heart cavity (pericardial mesothelioma), and the abdominal cavity (peritoneal mesothelioma). In the testicles, the mesothelium is known as the tunica vaginalis, a membranous lining that shields and supports the testicles. In the more common pleural, pericardial and peritoneal forms of mesothelioma, asbestos fibers lodge in the body’s soft tissues through inhalation or ingestion. It is not known how asbestos fibers can reach the tunica vaginalis and research is ongoing into the question of how testicular mesothelioma develops.
Because testicular mesothelioma is so rare, there are no widely recognized diagnostic criteria. In most reported cases, the only common symptom is a swelling of the scrotum and the development of lumps in the testicles. In some cases, testicular mesothelioma is diagnosed after the development of lumps; in other cases, the condition has been diagnosed when the patient was undergoing a different surgery (such as for a hernia) and the operating surgeon saw tumors or growths in the testicular region.
In some cases testicular mesothelioma is not the primary mesothelial tumor; the development of peritoneal (abdominal cavity) mesothelioma is sometimes the primary mesothelioma and the cancer spreads to the tunica vaginalis from the peritoneal region.
Treatment for testicular mesothelioma is straightforward: surgical removal of the affected portion of the testicle, or the entire testicle. Surgical intervention is followed up with radiation and/or chemotherapy treatments to minimize the risk of further spread of the cancer.
If the testicular mesothelioma is a secondary tumor resulting from a peritoneal mesothelioma case, the treatment is more involved and simple surgical removal of the cancerous portion of the testicle is unlikely to be an adequate treatment.
Testicular mesothelioma is an aggressive form of the disease, meaning that it tends to spread rapidly and widely in the body if not treated. For this reason, the prognosis for testicular mesothelioma patients is dependent in large part on the speed of diagnosis and the stage to which the cancer has developed. In cases where diagnosis is early and surgical removal is viable, patients can go on to live full healthy lives. In cases where diagnosis is late and the cancer has spread beyond the affected testicle, the prognosis is less optimistic.
Testicular mesothelioma is thought to be a recurrent form of mesothelioma, and patients who have tumors removed may have them appear again at a later date.
There is no currently accepted theory as to how asbestos exposure causes testicular mesothelioma. Researchers believe that the method of tumor formation is essentially the same in all cases of mesothelioma; asbestos fibers lodge in the thin mesothelial cells, where they are constantly attacked by the body’s own immune system as dangerous invaders.
Because asbestos fibers are essentially invulnerable to these attacks, the immune response rages out of control, causing further cell damage and making the surrounding tissues highly susceptible to tumor formation. Eventually cancer develops and spreads throughout the affected region, and beyond. As with other forms of mesothelioma, avoidance of asbestos exposure is the only known way to minimize risk.
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