[Unusual case of mesothelioma of the tunica vaginalis associated with prostatic adenocarcinoma].

Malignant mesothelioma of the tunica vaginalis testis, is a very rare neoplasm with highly aggressive biological behaviour. It usually occurs in patients aged between 55 and 75 years. A testicular mass is always observed, often accompanied with hydrocele. The response to chemotherapy and radiotherapy is poor. Initial aggressive surgery is necessary. The median survival, without surgical treatment is 23 months. A rare case of malignant mesothelioma of the tunica vaginalis testis, observed in a patient affected by prostate neoplasm is reported. A radical retropubic prostatectomy was performed. The patient was suffering from dysuria and there was a suspect area at the digital examination. Rectal ultrasonography and biopsy showed an adenocarcinoma at T1c clinical stage. A radical prostatectomy was carried out and histology showed an adenocarcinoma, Gleason score 7 pT3bN0M0. Surgery was followed by radiation therapy. After three years, a pleural seroma, a cutaneous mass and testicular nodule were observed and cytological examination showed endothelial cells. Scrotal orchiectomy was performed, because he was suffering from emphysema. Cytological examination confirmed malignant mesothelioma of the tunica vaginalis testis. Only 73 cases of this tumour have been reported in the last 30 years. The therapeutic options for this aggressive neoplasm are discussed. Since chemotherapy and radiation therapy had poor results, a rapid surgical treatment, by radical orchiectomy, is important.