Malignant Mesothelioma of the Tunica Vaginalis Testis: a Case Report.

We report here a case of malignant mesothelioma of the tunica vaginalis testis. A 93-year-old man with no history of asbestos exposure complained of increase of right scrotum size with pain. Ultrasonography and magnetic resonance imaging revealed a right hydrocele testis. A cytologic examination of the hydrocele fluid demonstrated mesothelial cells but show less atypicality and lack of obvious malignant features (class IIIa). We performed right hydrocelectomy for hydrocele testis. The pathological diagnosis was epithelial type of malignant mesothelioma of the tunica vaginalis testis, therefore we performed radical orchidectomy with wide excision of hemi-scrotal wall. There is no evidence of recurrence after 6 months of follow up. Malignant mesothelioma of the tunica vaginalis is rare, and accurate preoperative diagnosis is difficult. When a rapid increasing hemorrhagic hydrocele testis or nodular masses of the tunica vaginalis was observed, malignant mesothelioma should be considered. Malignant mesothelioma is highly fatal disease. Even two stage operation, radical orchidectomy should be performed.