Malignant mesothelioma of the tunica vaginalis: presenting with intermittent scrotal pain and hydrocele

Our plain-English summary of Malignant mesothelioma of the tunica vaginalis: presenting with intermittent scrotal pain and hydrocele, by T. Esen, O. Acar, K. Peker, et al (Case Reports in Medicine, 2012).

The study

• Authors: T. Esen, O. Acar, K. Peker, K. Sarman, A. Musaoglu, A. Tefekli
• Journal: Case Reports in Medicine
• Published: 2012;2012:189170
• Cited by: 6 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Paratesticular mesotheliomas are very rare tumors. In this paper, we present the management of a 38-year-old male patient with paratesticular malignant mesothelioma who was initially misdiagnosed and treated as recurrent epididymitis. After the final pathology report defining paratesticular mesothelioma during scrotal exploration, he underwent radical orchiectomy and hemiscrotal excision as a complementary, secondary procedure. His metastatic workup did not show any dissemination. Therefore, he did not receive any adjuvant treatment and remained disease-free for more than 2 years.

In plain English

This article is a case report about one 38-year-old man with malignant mesothelioma of the tunica vaginalis, the lining around the testis. For almost 1.5 years he had on-and-off left scrotal pain and swelling, and he received many medications for what was thought to be recurrent epididymitis. Ultrasound showed a hydrocele (fluid around the testis) and signs of epididymitis but no abnormality of the testis itself. Blood and urine tests, including tumor markers, were normal. During surgical exploration of the left scrotum, the removed tissue unexpectedly showed an epithelioid-type mesothelioma that measured 3 mm at its widest. He then had the left testis and half of the scrotum removed. Chest and abdominal CT scans and PET scans were negative. Pelvic lymph node biopsies taken at another center were also negative. He received no further treatment and was disease-free at 26 months. He denied any environmental, occupational or domestic exposure to the known causes. The authors concluded that such tumors should be kept in mind when evaluating chronic, recurrent scrotal symptoms.

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 (single patient)
• Who was studied: one 38-year-old man with left testicular pain and swelling and an otherwise unremarkable past medical history
• Exposure: The patient denied any environmental, occupational or domestic exposure to the documented causes the authors listed, which include asbestos, erionite, fluoroedenite and thorotrast. His family history was unremarkable.
• Main results:
  • Before diagnosis, the patient had intermittent swelling for almost 1.5 years and was given many medications for recurrent epididymitis.
  • Scrotal ultrasound showed no abnormality of the testis itself.
  • Blood and urine tests, including serum tumor markers, were normal.
  • Pathology of tissue removed at scrotal exploration showed epitheloid-type malignant mesothelioma arising from the tunica vaginalis, measuring 3 mm at its maximum diameter.
  • After diagnosis, he had a left radical orchiectomy and hemiscrotectomy. Chest and abdominal CT and PET scans were all negative.
  • At diagnostic laparoscopy performed at another center, all pelvic lymph node biopsies were negative.
  • With no additional treatment, the patient was disease-free at 26 months of follow-up.
• The authors' conclusion: The authors concluded that paratesticular tumors should always be kept in mind when evaluating chronic, recurrent symptoms on one side of the scrotum.
• Limitations the authors state:
  • The authors stated that firm recommendations about adjuvant therapy or staging laparoscopy for this tumor cannot be made from the limited data available.

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Tunica Vaginalis, Hydrocele, Testicular Mesothelioma, Paratesticular, Epididymitis, Pathology Report, Orchiectomy.

Related studies

• Primary Malignant Mesothelioma of the Tunica Vaginalis Presenting as a Benign Scrotal Mass: A Case Report — Z.C. Dagdeviren, O. Amac, et al. (2025)
• Malignant Epithelioid Mesothelioma of the Tunica Vaginalis Testis Presenting as Hydrocele in a Kidney Transplant Recipient — B.M. Behers, C.W. Guske, et al. (2024)
• Primary malignant mesothelioma of the tunica vaginalis presenting as hydrocele: imaging pitfalls — J. Naidu, N.G. Joseph, et al. (2026)
• Mesothelioma of the tunica vaginalis testis: a rare malignancy mimicking more common inguino-scrotal masses — P.J. Schure, K.C. van Dalen, et al. (2006)
• Malignant mesothelioma of the tunica vaginalis: a atypical presentation of a rare scrotal tumour — M.C. Harris, C. Logan, et al. (2019)
• Pre-operative diagnosis of malignant mesothelioma of tunica vaginalis testis by hydrocele fluid cytology — S.C. Gupta, A.K. Gupta, et al. (1998)

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