tumor focally infiltrates near the seminferous tubules (on the right) Image

papillary neoplasm with desmoplastic stroma- back to back papillary structures with almost impercetible fibrovascaular cores Image

psammomatous calcifications are frequent in this tumor. Image

The first case of malignant mesothelioma arising in the tunica vaginalis of testis was described by Barbera and Rubino in 1957. Overall, about 68–85% of mesotheliomas occur in the pleura, 9–24% in the peritoneum, and only 0.3–5% in the tunica vaginalis testis (Guney). Asbestos exposure

significantly increases the risk of developing a malignant mesothelioma by a factor of 10; potassium bromate in drinking water has also shown to increase the risk of in an animal model (Crosby).

In a review, more than two-thirds arose in those older than 45 years of age with a median

age of 60 years (Plas). This lesion often presents as an incidental finding during hydrocele surgery, particularly in patients with a history of asbestos exposure.

Although some tumors showed a response to radiotherapy or chemotherapy, adjuvant treatments such as chemotherapy or immunotherapy have limited effects in advanced disease (Plas).

Metastasis occurs early via the lymphatic system to inguinal, para-aortic or supraclavicular nodes, as well as lung and liver. In one review, tumor recurrence was more than 60% within 2 years and

over 90% within 5 years (Plas). Overall, prognosis is poor.