Malignant Mesothelioma of the Tunica Vaginalis: Presenting with Intermittent Scrotal Pain and Hydrocele

Abstract

Paratesticular mesotheliomas are very rare tumors. In this paper, we present the management of a 38-year-old male patient with paratesticular malignant mesothelioma who was initially misdiagnosed and treated as recurrent epididymitis. After the final pathology report defining paratesticular mesothelioma during scrotal exploration, he underwent radical orchiectomy and hemiscrotal excision as a complementary, secondary procedure. His metastatic workup did not show any dissemination. Therefore, he did not receive any adjuvant treatment and remained disease-free for more than 2 years.

Biphasi̇c Malignant Mesothelioma of the Testis: Case Report

“…The mean life expectancy is 23 months 2 . No recurrence or metastasis occurred in this case during postoperative 13 months follow-up period.…”

“…The clinical manifestations of PMM are nonspecific. Testicular pain, swelling and scrotal stretch may be observed 2 . Testicular tumor markers are within normal range.…”

Mesothelioma of the tunica vaginalis in a patient with giant hydrocele

“…There are less than 300 cases published in the literature since the entity was first described by Barbera et al in 1957 ( 3 ) . Asbestos exposure is considered to be the main risk factor ( 4 ) . Other predisposing factors have been described, such as previous trauma, herniorrhaphy, and long-standing hydrocele ( 5 , 6 ) .…”

“…Other predisposing factors have been described, such as previous trauma, herniorrhaphy, and long-standing hydrocele ( 5 , 6 ) . The presence of a painless scrotal mass associated with reactive and recurrent hydrocele - a feature observed in more prevalent and benign testicular conditions - makes it more difficult to suspect of a malignant etiology ( 1 , 4 ) .…”

“…Radical inguinal orchiectomy with en bloc resection of the tunica vaginalis is the treatment of choice for paratesticular malignant mesothelioma. Recurrence is described in approximately 60% of cases ( 1 , 4 ) .…”