We report a case of malignant mesothelioma of tunica vaginalis testis in a 69 year old man which was diagnosed post operatively as a surprise with a review of the literature. Since its first description in 1957 by Barbera and Rubino 9, only about 90 cases have been reported to our knowledge in the world literature 10 11. The tumour could be solid or cystic with yellow or white colour and a relatively firm consistency 5. Malignant mesothelioma of the tunica vaginalis testis is rare and occurs in 0.3 to 5 % of all malignant mesotheliomas 6 7 8. Mesothelioma is also known to arise in the peritoneum, pericardium or tunica vaginalis uncommonly 4 5. Malignant mesothelioma is a diffuse mass that usually spreads widely in the pleural space and it is associated with extensive pleural effusion as well as direct invasion to thoracic structures besides metastatic spread 1 2 3. Key Words: Malignant Mesothelioma Tunica vaginalis Testis Hydrocele. Histopathological examination with immunohistochemistry is the usual way of confirming the diagnosis of MMTVT. Pre-operative diagnosis of malignant mesothelioma of tunica vaginalis testis is usually missed in the absence of a nodule or nodules on physical examination or scrotal ultrasound scan. Immuno-histochemiistry is required for confirmation of diagnosis. The Diagnosis must be suspected when a nodule or nodules are found on clinical examination or ultrasound. Literature review confirmed that MMTV is a rare condition. Histological examination of the excised Tunica Vaginalis revealed malignant mesothelioma. The scrotum was explored and the intra-scrotal collection was evacuated and left orchidectomy as well as excision of the surrounding oedematous tissue was performed. and poor Doppler flow to the left testis. Ultrasound scan revealed a large left hemi scrotal swelling with septae and echogenic debris compressing both testicles. He developed a further left sided hemi-scrotal oedematous painful scrotal swelling two weeks post-operatively. He underwent a left sided hydrocelectomy. Objective: To report a case of malignant mesothelioma of the tunica vaginalis testis with a review of the literature.Ī 69-years-old man presented with a left hemi-scrotal mass which was diagnosed clinically and by ultrasound scan to be consistent with left sided hydrocele. In view of this most practitioners would be unaware of the characteristic features of the tumour. Malignant Mesothelioma of Tunica Vaginalis testis (MMTVT) is a very rare tumour which most medical practitioners would not come across in their life time.
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