Combined Therapy in a Case of Malignant Mesothelioma of the Tunica Vaginalis Testis

Malignant mesothelioma of the tunica vaginalis testis is exceedingly rare. A new case mimicking hydrocele in a 47-year-old man is here reported. Clinical staging revealed scrotal cutaneous and funicular tumor invasion together with retroperitoneal adenopathies. Once visceral dissemination was ruled out, radical orchiectomy, left hemiscrotectomy and modified retroperitoneal lymph node dissection were performed. Adjuvant systemic chemotherapy and radiation were also administered. Histologically, an epithelial neoplasm with papillary pattern was evidenced. CAM 5.2 cytokeratin was positive in proliferating cells, but carcinoembryonic and Leu M1 antigens gave negative results. Three years later the patient is free of disease.