A rare case of malignant hydrocele in a young patient

Lima, George Rafael Martins de; Oliveira, Vladmir P.; Reis, Paulo Henrique de Moura; Pinheiro, Fábio Gurgel do Amaral; Lima, Marcos Venício Alves; Gonzaga-Silva, Lúcio Flávio

doi:10.1016/j.jpurol.2008.10.010

Cited by 10 publications

(2 citation statements)

References 9 publications

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“…Conventional malignant mesotheliomas may develop in the tunica vaginalis of children. [274][275][276][277] The youngest reported patient was a 6 years old 275 ; in the review by Plas et al, 276 4% of malignant mesotheliomas of the tunica vaginalis occurred between 7 and 14 years of age. Most patients present with scrotal swelling that clinically is felt to represent a simple hydrocele.…”

Section: Mesotheliomamentioning

confidence: 99%

Testicular and paratesticular tumors and tumor-like lesions in the first 2 decades

Ulbright

Young

2014

Seminars in Diagnostic Pathology

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Section: Mesotheliomamentioning

confidence: 99%

Testicular and paratesticular tumors and tumor-like lesions in the first 2 decades

Ulbright

Young

2014

Seminars in Diagnostic Pathology

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“…The differential diagnosis between reactive mesothelial hyperplasia and mesothelioma should always be carefully made. Despite the extreme rarity of mesothelioma during childhood, de Lima et al report a case of a 15-year-old boy with secondary hydrocele and malignant mesothelioma as the etiologic substrate (31).…”

Section: Discussionmentioning

confidence: 99%

Tunica Vaginalis Thickening, Hemorrhagic Infiltration and Inflammatory Changes in 8 Children with Primary Hydrocele; Reactive Mesothelial Hyperplasia? A Prospective Clinical Study

Patoulias

Rachmani

Kalogirou

et al. 2018

Acta Med. (Hradec Kralove, Czech Repub.)

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The aim of this study is to describe an entity of primary hydrocele accompanied with fibrosis, thickening and hemorrhagic infiltration of parietal layer of tunica vaginalis (PLTV). During a 4-year period (2011-2014), 94 boys (2.5-14 years old) underwent primary hydrocele repair. Hydrocele was right sided in 55 (58.5 %), left sided in 26 (28.7%) and bilateral in 12 patients (13.8%). Eighty three out of 94 patients (88.30%) had communicating hydrocele and the rest eleven patients (11.7%) had non-communicating. Our case group consists of 8 patients (8.51%) based on operative findings consistent with PLTV induration, thickening and hemorrhagic infiltration. Preoperative ultrasonography did not reveal any pathology of the intrascrotal structures besides hydrocele. There weren't hyperechoic reflections or septa within the fluid. Evaluation of thickness of the PLTV was not feasible. Presence of lymph or exudate was excluded after fluid biochemical analysis. Tunica vaginalis histological examination confirmed thickening, hemorrhagic infiltration and inflammation, while there was absence of mesothelial cells. Immunochemistry for desmin was positive, excluding malignant mesothelioma. One patient underwent high ligation of the patent processus vaginalis and PLTV sheath fenestration, but one year later, he faced a recurrence. An elective second surgery was conducted via scrotal incision and Jaboulay operation was performed. The latter methodology was our treatment choice in other 7 out of 8 patients. During a 2-year postoperative follow-up, no other patient had any recurrence. We conclude that in primary hydrocele with macroscopic features indicative of tunica vaginalis inflammation, reversion of the tunica should be a part of operative strategy instead of sheath fenestration, in order to minimize the recurrence.

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