Well-differentiated mesothelioma of tunica vaginalis: one case report with literature review

Abstract

Objective To explore the clinical manifestations, imaging features, pathological features, and treatment of well-differentiated papillary mesothelioma of tunica vaginalis, and to deepen the understanding of this disease. Methods The clinical data of a patient with well-differentiated papillary mesothelioma of tunica vaginalis were retrospectively analyzed. Results The patient underwent resection of the right testicular, sheath, and spermatic cord. During the operation, we could saw that the testes looked grey, with poor blood flow and multiple cauliflower vegetations in tunica vaginalis. Postoperative pathology showed that the testis was the size of 6.0 cm×3.0 cm×3.0 cm; the cut surface was yellowish; the epididymis was 8.0 cm in length and 1.0 cm in diameter. There were multiple papillary protrusions on the surface of the testis, with a diameter of 0.4-1.0 cm. In microscopic observation, mildly heterosexual papillary hyperplasia-like epithelial cells were displayed on tunica vaginalis, and it was diagnosed as well-differentiated papillary mesothelioma of tunica vaginalis. Conclusions Radical orchiectomy plus scrotal skin resection is the recommended treatment for malignant tunica vaginalis mesothelioma. Chemotherapy may be performed if necessary. There is no definite treatment for well-differentiated papillary mesothelioma in testis. This patient underwent radical right testicular surgery, and further follow-up was needed to assess the prognosis. Key words: Testicular sheath tumor; Highly differentiated papilloma; Mesothelioma