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A 64-year-old man with decades of occupational asbestos exposure presented with a chronic hydrocoele. Hydrocoelectomy revealed abnormal tunica vaginalis tissue, leading to radical orchiectomy; histology confirmed MMTVT. Completion hemiscrotectomy with cord excision and inguinal lymph node dissection was performed, and follow-up showed no disease. Integrated with the literature, the report emphasizes clinical suspicion in chronic hydrocoele with asbestos exposure and the central role of radical surgery for treatment.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/malignant-mesothelioma-of-the-tunica-vaginalis-a-case-report-and-comprehensive-literature-review/451008/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/malignant-mesothelioma-of-the-tunica-vaginalis-a-case-report-and-comprehensive-literature-review/451008.png","ImageObject",300,407,{"name":92,"@type":93},"Putri","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is diagnosis often delayed in malignant mesothelioma of the tunica vaginalis?","Question",{"text":112,"@type":113},"The condition often mimics benign hydrocoele or other scrotal pathology, so early recognition is difficult. Ultrasound findings may be non-specific and can resemble complex hydrocoele or benign conditions.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was the diagnosis confirmed in the presented case?",{"text":117,"@type":113},"Hydrocoelectomy showed abnormal tunica vaginalis tissue, prompting radical orchiectomy. Histology demonstrated atypical mesothelial proliferation with papillary and tubular architecture, and immunohistochemistry supported malignant epitheloid mesothelioma.",{"name":119,"@type":110,"acceptedAnswer":120},"What treatment approach was used after initial orchiectomy?",{"text":121,"@type":113},"After histologic confirmation, staging CT showed no metastases. The patient then underwent completion hemiscrotectomy with cord excision and left inguinal lymphadenectomy, followed by ongoing surveillance with no residual disease reported.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},451008,1790789692,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":19,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":52,"preview_page_count":4},962085571259,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","Urology Case Reports 64 (2026) 103315  \nContents lists available at ScienceDirect  \nUrology Case Reports  \njournal [homepage:](homepage: www.elsevier.com/locate/eucr)[ www.elsevier.com/locate/eucr](homepage: www.elsevier.com/locate/eucr)  \n| Oncology\u003Cbr>Malignant mesothelioma of the tunica vaginalis: A case report and comprehensive literature review |  |  | |\n| --- | --- | --- | --- |\n| Joshua Tiroa,* , Flavio Vasconcelas Ordonesa,b, Peter John Gillinga,b, Lodewikus Petrus Vermeulena,b\u003Cbr>a Urology Department, Tauranga Hospital, Tauranga, Bay of Plenty, New Zealand b Auckland University, Tauranga Campus, Tauranga, Bay of Plenty, New Zealand |  |  |  |\n| A R T I C L E I N F O |  | A B S T R A C T |  |\n| Keywords:\u003Cbr>Tunica vaginalis Mesothelioma Hydrocoele Asbestos exposure Orchiectomy Hemiscrotectomy |  | Malignant mesothelioma of the tunica vaginalis testis (MMTVT) is an exceedingly rare neoplasm, representing \u003C1 % 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. |  |\n\n1. Introduction  \nMalignant mesothelioma most commonly arises in the pleura and peritoneum. The tunica vaginalis testis is an exceptionally rare site, accounting for \u003C1 % of all cases.1 Since the first description by Barbera and Rubino in 1957, just under 300 cases have been documented worldwide.2 Owing to its rarity, management strategies are based on case reports, small series, and systematic reviews. The condition often mimics benign hydrocoele or scrotal pathology, delaying diagnosis.  \nWe present a case of MMTVT from our unit, followed by a comprehensive review of the literature. Our aim is to contextualise this case within the broader evidence base and to highlight current challenges in diagnosis, treatment, and prognosis.  \n2. Case presentation  \nA 64-year-old otherwise healthy man presented with a seven-year history of progressive left-sided hydrocoele. He reported decades of occupational exposure to asbestos while working as a painter on asbestos-containing roofs. He denied systemic symptoms. Clinical examination was consistent with a left-sided hydrocele. Routine laboratory tests, including full blood count and renal function, were normal. Ultrasonography confirmed a complex, septated left hydrocoele without suspicious intratesticular nodules or masses.  \nHe was scheduled for left hydrocoelectomy. Intraoperatively, the tunica vaginalis and testis appeared grossly abnormal with an inflammatory character, prompting conversion to radical orchiectomy with excision of the tunica. Histopathology demonstrated atypical mesothelial proliferation (Fig. 1) exhibiting a papillary and tubular architecture (100 % epitheloid morphology) invading the tunica vaginalis (Figs. 2 and 3). Immunohistochemistry exhibited expression of CK, CK-5, Calretinen and WT1; consistent with a diagnosis of malignant epitheloid mesothelioma.  \nStaging CT of the chest, abdomen, and pelvis showed no metastatic disease. The patient subsequently underwent completion left hemiscrotectomy with cord excision and left inguinal lymphadenectomy. Recovery was uneventful, and final pathology confirmed no residual disease and no nodal involvement. He remains disease-free at follow-up (18 months) and has been committed to surveillance.  \n3. Discussion  \n3.1. Epidemiology  \nMMTVT is extremely rare. In a SEER registry analysis of 52 cases over four decades, the incidence was estimated at 0.7 % of all male mesotheliomas, with a median a","cbCaij0dN85TrDhE","https://ap.wps.com/l/cbCaij0dN85TrDhE","pdf",4423226,"English","# Introduction\n## Case presentation\n## Discussion\n### Epidemiology\n### Risk factors\n### Clinical presentation\n### Diagnostic approach and pitfalls","[{\"question\":\"Why is diagnosis often delayed in malignant mesothelioma of the tunica vaginalis?\",\"answer\":\"The condition often mimics benign hydrocoele or other scrotal pathology, so early recognition is difficult. Ultrasound findings may be non-specific and can resemble complex hydrocoele or benign conditions.\"},{\"question\":\"How was the diagnosis confirmed in the presented case?\",\"answer\":\"Hydrocoelectomy showed abnormal tunica vaginalis tissue, prompting radical orchiectomy. Histology demonstrated atypical mesothelial proliferation with papillary and tubular architecture, and immunohistochemistry supported malignant epitheloid mesothelioma.\"},{\"question\":\"What treatment approach was used after initial orchiectomy?\",\"answer\":\"After histologic confirmation, staging CT showed no metastases. The patient then underwent completion hemiscrotectomy with cord excision and left inguinal lymphadenectomy, followed by ongoing surveillance with no residual disease reported.\"}]","Malignant mesothelioma of the tunica vaginalis - A case report and comprehensive literature review | PDF",1790734200]