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Open Access Open Badges Case Report

Mesothelioma of tunica vaginalis of "uncertain malignant potential" - an evolving concept: case report and review of the literature

Kiril Trpkov1*, Richard Barr2, Andrew Kulaga1 and Asli Yilmaz1

Author Affiliations

1 Department of Pathology and Laboratory Medicine, Calgary Laboratory Services and University of Calgary, Rockyview General Hospital, 7007 14 st, Calgary, T2V 1P9, Alberta, Canada

2 Division of Urology, Southern Alberta Urology Institute and Alberta Health Services, Rockyview General Hospital, 7007 14 st, Calgary, T2V 1P9, Alberta, Canada

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Diagnostic Pathology 2011, 6:78  doi:10.1186/1746-1596-6-78

Published: 25 August 2011


Mesothelioma of tunica vaginalis is a rare neoplasm, typically demonstrating frankly malignant morphology and aggressive behavior. Rare cases of well-differentiated papillary mesotheliomas have also been reported, which, in contrast, demonstrate indolent behavior. There are, however, cases which do not fit into the well-differentiated or diffuse malignant mesothelioma categories and can be considered mesothelioma of tunica vaginalis of "uncertain malignant potential", which is an emerging diagnostic category. A 57-year-old man presented with a neoplasm in a hydrocele sac. The neoplasm was non-invasive, but showed focal complex and solid growth and it was difficult to categorize either as well-differentiated papillary mesotheliomas or malignant mesothelioma. After the initial limited resection, the patient underwent radical orchiectomy with hemiscrotectomy and is alive and without disease progression after 6 years. Documentation of these rare tumors will allow their distinction from true malignant mesotheliomas and will facilitate the development of specific treatment recommendations.

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mesothelioma; tunica vaginalis; well-differentiated papillary mesothelioma; malignant mesothelioma