M Bertolotto1, I Boulay-Coletta2, R Butini3, S M Dudea4, N Grenier5, G Oltmanns6, P Ramchandani7, M W Stein8, M Valentino9, Lorenzo E Derchi10,11. 1. Department of Radiology, University of Trieste, Trieste, Italy. 2. Service d'Imagerie Medical, Fondation Hopital Saint Joseph, Paris, France. 3. Department of Radiology, Ospedale S. Giacomo, Castelfranco Veneto, TV, Italy. 4. Department of Radiology, Univ. Med. Pharm. "Iuliu Hatieganu", Cluj-Napoca, Romania. 5. Department of Radiology, Pellegrin Hospital, Place Amelie Raba Leon, 33076, Bordeaux, France. 6. Department of Radiology, University Hospital of North Norway, Tromsø, N9038, Norway. 7. Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA. 8. Department of Radiology, Albert Einstein College of Medicine, Montefiore Medical Center, 111 E. 210th Street, Bronx, NY, 10467, USA. 9. Department of Radiology, Sant'Antonio Hospital, Tolmezzo, UD, Italy. 10. Department of Health Sciences, University of Genoa, Largo R. Benzi, 10, Genova, Italy. derchi@unige.it. 11. Radiologia d'Urgenza, IRCCS Azienda Ospedaliera Universitaria San Martino IST, Largo R. Benzi, 10, I-16122, Genova, Italy. derchi@unige.it.
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.
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.
Authors: Athina C Tsili; Michele Bertolotto; Ahmet Tuncay Turgut; Vikram Dogra; Simon Freeman; Laurence Rocher; Jane Belfield; Michal Studniarek; Alexandra Ntorkou; Lorenzo E Derchi; Raymond Oyen; Parvati Ramchandani; Mustafa Secil; Jonathan Richenberg Journal: Eur Radiol Date: 2017-07-11 Impact factor: 5.315
Authors: Luigi Vimercati; Domenica Cavone; Maria Celeste Delfino; Luigi De Maria; Antonio Caputi; Giovanni Maria Ferri; Gabriella Serio Journal: Environ Health Date: 2019-08-30 Impact factor: 5.984