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Malignant mesothelioma of the tunica vaginalis
Departments of Surgery, Medicine, and Pathology, McGill University Health Centre, Montreal, Quebec, Canada
Apr  2007 (Vol.  14, Issue  2, Pages( 3514 - 3517)
PMID: 17466159


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    Malignant mesothelioma involving the tunica vaginalis is an extremely rare tumor. CASE: We describe a case of a 39-year-old man who initially presented with discomfort in the left testis and underwent resection of a hydrocele in the left testis. A pathology examination of a frozen section of a lesion on the tunica identified the lesion as mesothelioma, which was confirmed by a second pathology examination. No metastatic disease was found. The patient subsequently underwent a left radical orchiectomy and a partial scrotectomy, and has been disease free for 7 years. DISCUSSION: The first case of malignant mesothelioma involving the tunica vaginalis, a structure embryologically derived from a layer of reflected peritoneum known as the "processus vaginalis," was reported in 1957. Only 73 cases were reported in the literature between 1966 and 1997. In up to 41% of cases, there is a positive history of asbestos exposure. Young age and localized disease are associated with a better prognosis. Radical orchiectomy limits recurrence, which usually occurs within 2 years, but may occur up to 15 years after surgery.