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Malignant mesothelioma of tunica vaginalis testis: Report of an extremely rare case with all the literature.

Malignant mesothelioma of tunica vaginalis testis: Report of an extremely rare case with all the literature.

Archivio Italiano di Urologia, Andrologia 2018 September 30 [Link]

Trenti E1, Palermo SM, D’Elia C, Comploj E, Pycha A, Carella R, Pycha A


Mesothelioma of the tunica vaginalis testis is a very rare tumor and signifies 0.3 to 0.5percent of malignant mesotheliomas. Exposure to asbestos frequently precedes disease. Due to its low prevalence and nonspecific clinical presentation, it’s largely diagnosed accidentally during surgery for other reasons and the prognosis is generally poor. We now present a case of a patient having a mesothelioma of tunica vaginalis testis, diagnosed secondarily during hydrocele operation, together with long-term survival following radical operation.
a 40 years old patient had been admitted to the department for regular operation of a left hydrocele. During the surgery a frozen section analysis was asked due to the unusual nodular thickening of the tunica vaginalis: the evaluation demonstrated a diffuse malignant mesothelioma using epithelioid arrangement and tubular-papillary proliferation. Hence a left hemi-scrotectomy with left pulmonary lymph node dissection has been performed.
The definitive histology confirmed the prior record of diffuse malignant mesothelioma using angio-invasion but standard testicle findings and negative lymph nodes. No metastases were discovered around the CT-scan. For the initial 2 years that the CT has been repeated every four months, for additional 3 years each 6 months and then yearly. Six years after operation the patient is categorized as no signs of disease.
malignant mesothelioma of the tunica vaginalis testis is a rare thing, frequently originally regarded as a hydrocele or a epididymal cyst. An aggressive strategy to hemiscrotectomy with or without inguinal and retroperitoneal lymphadenectomy can lessen the possibility of recurrence.

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