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Case Study Suggests Aggressive Surgery as First-Line Treatment for Testicular Mesothelioma


Testicular mesothelioma develops in the tunica vaginalis testis, the lining of the testes. It is the rarest form of mesothelioma and accounts for less than 1% of all cases. Patients diagnosed with testicular mesothelioma survive 20 – 23 months on average. Researchers continually seek new ways to improve a patient’s life expectancy and quality of life through treatment.

A French case study examined a patient with testicular mesothelioma to determine effective treatment methods for the disease. Because the cancer can metastasize, or spread, to other areas of the body in its advanced stages, researchers noted aggressive surgery should be administered as early as possible for eligible patients.


Testicular Mesothelioma Relapse May Present in Lymph Node Metastasis

Testicular mesothelioma is a rare form of the disease, with a median survival time of approximately 20 – 23 months. However, some patients may live longer depending on age, stage at diagnosis and cell type. This is a more favorable life expectancy than other forms of mesothelioma, some of which have a median life expectancy of one year.

Because this form of mesothelioma is so rare, researchers have not identified a standard treatment plan. Previous literature has referenced a treatment plan of radical orchidectomy (also known as orchiectomy) without removing lymph nodes in the groin (inguinal lymph nodes). An orchidectomy is a surgical procedure to remove one or both testicles.

In this latest case study, experts recommended a more aggressive surgery plan in order to prevent or slow metastasis for testicular mesothelioma patients. Researchers used the common first-line treatment for the patient in this study, which involved removal of the testicles. The patient had a predictable relapse. However, researchers believe the patient noted in this case study would have had a more favorable outcome if he had received a more aggressive treatment plan.

Research indicated the incidence of lymph node metastasis in testicular mesothelioma is rare. However, studies show testicular mesothelioma has the potential to metastasize to the lymph nodes, which can then easily spread to the lungs and other areas of the body.

Researchers Recommend Lymph Node Resection to Treat Testicular Mesothelioma

Experts analyzed the case of a 71-year-old male patient diagnosed with epithelioid testicular mesothelioma to determine the best treatment plan for the cancer. While the patient was not known to have been exposed to asbestos occupationally or in his home life, he had a 20-year history of smoking.

The patient first presented symptoms of hydrocele, or the swelling of the scrotum, during a routine prostate exam. He was diagnosed through a testicular ultrasound. Because the imaging test showed no metastasis at the time, the patient underwent a radical inguinal orchidectomy to remove both testicles affected by mesothelioma.

Two years later, the patient’s mesothelioma returned and metastasized to his lymph nodes. Chemotherapy was then administered. Following six cycles of chemotherapy, stable disease was achieved, which means the cancer did not spread for a given period of time. However, the patient’s disease progressed to his lungs eight months later.

In discussing the patient’s case, the researchers noted radical orchidectomy is the most common treatment for testicular mesothelioma. The treatment is the typical first-line method for patients in earlier stages of the disease. From the previous study, the researchers noted:

  • Radical orchidectomy yields a median overall survival time of 24 months.
  • Testicular mesothelioma recurs within two years in about 60% of cases treated with the surgery.
  • The median survival time is approximately 12 months after recurrence.

As with other forms of cancer, testicular mesothelioma can easily advance to other areas of the body once it has metastasized to the lymph nodes. Due to this, researchers suggest lymph node resection with orchidectomy. Doctors also recommended monitoring a patient’s condition with PET-CT scans following treatment.

A more aggressive approach to treating testicular mesothelioma may yield more favorable outcomes in both prognosis and quality of life. This procedure could slow or prevent metastasis, which may extend life expectancy.