Malignant mesothelioma of the tunica vaginalis testis (MMTVT) is a rare disease with a poor prognosis. The diagnosis and management of these lesions are often difficult for pathologists, surgeons, oncologists and occupational physicians. A preoperative diagnosis of malignancy is rarely made, and there is no established effective therapy except orchidectomy. A systematic literature review was conducted among the articles published in the English literature on primary MMTVT. Moreover four cases from the Apulia mesothelioma register are reported here. Two hundred eighty-nine cases of MMTVT have been reported from 1943 to 2018. Overall asbestos exposure has been investigated only for 58% of all cases reported in this review, while in 41.8% this data are not available. Noteworthy is the fact that in many reports there is not an anamnestic reconstruction of any asbestos exposure. A history of direct occupational, environmental or familial asbestos exposure is found in 27.6% of the cases. The four cases from the Apulia mesothelioma register are all with ascertained occupational exposure to asbestos. The true incidence of asbestos exposure in MMTVT is underestimated because of insufficient information reported in older literature. To establish a broad consensus on the causal relationship between asbestos and MMTVT in the scientific community its necessary to analyze the same variables in the epidemiological studies. In general it should be recommended that a positive history of exposure to asbestos or to asbestos–containing materials are at risk for the development of a MMTVT and should be monitored.

中文翻译：

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石棉暴露与睾丸阴道膜恶性间皮瘤：系统回顾和普利亚（意大利南部）间皮瘤登记册的经验


睾丸阴道恶性间皮瘤（MMTVT）是一种罕见疾病，预后不良。对于病理学家、外科医生、肿瘤学家和职业医生来说，这些病变的诊断和处理通常很困难。很少进行术前诊断为恶性肿瘤，并且除睾丸切除术外尚无有效的治疗方法。对英文文献中发表的关于初级 MMTVT 的文章进行了系统的文献综述。此外，这里还报告了普利亚间皮瘤登记册中的四例病例。从 1943 年到 2018 年，共报告了 289 例 MMTVT 病例。本综述中仅对 58% 的石棉暴露情况进行了调查，而 41.8% 的病例没有数据。值得注意的是，许多报告都没有对任何石棉暴露情况进行记忆重建。 27.6% 的病例有直接职业、环境或家庭石棉接触史。普利亚间皮瘤登记册中的四例病例均已确定有石棉职业接触史。由于旧文献报道的信息不足，MMTVT 中石棉暴露的真实发生率被低估。为了在科学界就石棉与 MMTVT 之间的因果关系达成广泛共识，有必要在流行病学研究中分析相同的变量。一般来说，应建议有接触石棉或含石棉材料的阳性病史的人有发生 MMTVT 的风险，应予以监测。