Malignant mesothelioma of the tunica vaginalis is an exceptional tumor, which can be a fatal disease. Malignant mesothelioma is more often originating from the pleura or retroperitoneum. We report the original case of a-89-year-old Caucasian man, presenting with a voluminous right hydrocele that appeared four years ago. The patient did not report any significant comorbidity. The patient underwent surgery. At surgical exploration, several lesions closely near right testis and on the vaginalis. The lesion measured 3 x 2 cm and 1 x 0.8 cm. These specimens demonstrated signs of malignancy. On histological examination it is a tumor characterized by proliferation connective and hyaline axis surmounted bycuboidal cells with high mitotic pluristratified.
The tumor was limited to the inner leaflet of the outer vaginalis without vegetation. Occasional mitotic figures were also present.
On this basis the diagnosis of malignant mesothelioma of the tunica vaginalis testis was done, confirmed by MESOPATH netgroup. The case was presented in multidisciplinary genitourinary round and surveillance was done.
The prognosis of these tumors is often defavorable, depending on the extension of the disease. Mesothelioma of the tunica vaginalis testis represents challenging in the management, because of a difficult diagnosis and no recommendation in the treatment after surgery.
F Lai-Tiong, D Girier and H Chapuis
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