Expert Consensus on the Diagnosis and Treatment of Malignant Mesothelioma of the Tunica Vaginalis Testis (IMAGE)
Caption
This figure outlines diagnostic and management consensus of MMTVT, including 4 key modules: the screening, diagnosis, treatment, follow-up.
(1) Screening: For those aged 60-80 (mainly), with asbestos exposure/ living in high-risk areas, and symptoms like hydrocele, conduct MMTVT-specific assessments to rule out malignancy; (2)Diagnosis: US (first choice) for screening; CT/MRI for tumor extent; PET/CT for staging/response. Histopathology (with ≥3 mesothelial markers) is gold standard. Sequencing for recurrent cases’ mechanism; multidisciplinary consultation to reduce misdiagnosis; (3)Treatment:Radical inguinal orchiectomy for localized lesions (no contraindications);prioritize surgery for recurrence. High-risk patients need enhanced follow-up.Individualized postoperative chemoradiotherapy (adjust first-line regimens/dosages as needed); (4) Follow-up: Every 3 months (first 2 years), yearly (years 2-5); lifelong monitoring (due to late recurrence risk). Multidisciplinary collaboration + individualized management improve prognosis.
Abbreviation
MMTVT, Malignant Mesothelioma of the Tunica Vaginalis Testis; US, Ultrasonography; CT, Computed tomography; MRI, magnetic resonance imaging;
Credit
Yiqing Cai , Chunwei Xu , Jing Lin,Qian Wang,Wenxian Wang,Zhenying Guo ,Enyong Dai,Yuanzhi Lu,Yu Chen
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