Malignant mesothelioma of the tunica vaginalis: A case report and comprehensive literature review

Our plain-English summary of Malignant mesothelioma of the tunica vaginalis: A case report and comprehensive literature review, by J. Tiro, F. Vasconcelas Ordones, P.J. Gilling, et al (Urology Case Reports, 2026).

The study

• Authors: J. Tiro, F. Vasconcelas Ordones, P.J. Gilling, L.P. Vermeulen
• Journal: Urology Case Reports
• Published: 2026;64:103315
• Type of article: Case report
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Malignant mesothelioma of the tunica vaginalis testis (MMTVT) is an exceedingly rare neoplasm, representing <1 % of all mesothelioma cases. We report a 64-year-old male with prolonged occupational asbestos exposure presenting with a chronic hydrocoele. Hydrocoelectomy revealed abnormal tunica vaginalis tissue, prompting radical orchiectomy. Histology confirmed MMTVT. Subsequent hemiscrotectomy with cord excision and inguinal lymph node dissection was performed and he remains disease free on follow up. Integrated with the largest body of literature available, this case highlights the need for heightened clinical suspicion in chronic hydrocoele with asbestos exposure, and the role of radical surgery as the cornerstone of treatment.

© 2025 The Authors. Published by Elsevier Inc.

In plain English

This article was a case report from the Urology Department of Tauranga Hospital in New Zealand, followed by a review of published literature. It described a 64-year-old man who had had a growing fluid collection around his left testicle (a hydrocoele) for seven years. He reported decades of work exposure to asbestos as a painter on asbestos-containing roofs. The article did not name a fiber type. During planned surgery to remove the hydrocoele, the testis and its lining (the tunica vaginalis) looked abnormal, so surgeons removed both. Tissue tests showed malignant epithelioid mesothelioma of the tunica vaginalis. Scans of the chest, abdomen and pelvis showed no spread. He then had further surgery to remove half of the scrotum, the spermatic cord and lymph nodes in the left groin. No remaining cancer and no lymph node involvement were found, and he was disease-free at 18 months. The review section summarized other researchers' work on this rare cancer. The authors concluded that doctors should stay alert in chronic hydrocoele, particularly with asbestos exposure, and that radical surgery remains the cornerstone of treatment.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report of a single patient, followed by a narrative literature review
• Who was studied: one 64-year-old man with a seven-year history of left-sided hydrocoele, treated at the Urology Department, Tauranga Hospital, New Zealand
• Exposure: decades of occupational asbestos exposure as a painter on asbestos-containing roofs; no fiber type or dose given
• Main results:
  • During planned hydrocoele surgery, the tunica vaginalis and testis looked grossly abnormal, and the operation was converted to radical orchiectomy (removal of the testis)
  • Histology and immunohistochemistry of the patient's tissue were consistent with malignant epithelioid mesothelioma (100% epithelioid)
  • Staging CT of the chest, abdomen and pelvis showed no spread of disease in this patient
  • After further surgery (hemiscrotectomy, cord excision and left inguinal lymph node removal), pathology found no residual disease and no lymph node involvement
  • The patient was disease-free at 18 months of follow-up
• The authors' conclusion: The authors concluded that the case shows the importance of diagnostic vigilance in chronic hydrocoele, particularly with asbestos exposure, and that radical surgery remains the cornerstone of treatment

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Tunica Vaginalis, Neoplasm, Asbestos Exposure, Orchiectomy, Histology, Hemiscrotectomy.

Related studies

• Mesothelioma of the Tunica Vaginalis Testis: Diagnostic and Therapeutic Management. A Comprehensive Review, 1982-2024 — S. Stella, G.L. Ceresoli, et al. (2024)
• Malignant mesothelioma of the tunica vaginalis. A clinicopathologic analysis of 11 cases with review of the literature — M.A. Jones, R.H. Young, et al. (1995)
• Malignant mesothelioma of the tunica vaginalis testis: a rare case and review of literature — M. Drevinskaite, A. Patasius, et al. (2020)
• Malignant mesothelioma of the tunica vaginalis testis: a case report and literature review — J.L. Chen, Y.H. Hsu (2009)
• Mesothelioma of tunica vaginalis of "uncertain malignant potential" - an evolving concept: case report and review of the literature — K. Trpkov, R. Barr, et al. (2011)
• Malignant mesothelioma of tunica vaginalis testis: Report of a very rare case with review of the literature — E. Trenti, S.M. Palermo, et al. (2018)

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