Treatment of mesothelioma of the tunica vaginalis testis.

We report a rare case of malignant mesothelioma of the tunica vaginalis testis. A 67-year-old man was hospitalized with a complaint of swelling on the right side of the scrotal contents. Right high orchiectomy was performed, and the pathological examination revealed malignant mesothelioma of the tunica vaginalis testis. The surgery was thought to have been radical, but 4 months postoperation, local recurrence in the inguinal skin and distant metastasis in the para-aortic lymph node were found. The tumors were treated by surgical resection and radiation therapy. Two months after the second treatment, multiple lung metastasis and a second local recurrence in the inguinal skin were found. High-dose chemotherapy with cisplatin and doxorubicin was performed, but no change was confirmed after 4 weeks. The disease progressed, resulting in death within 8 months of diagnosis. The response of mesothelioma to chemotherapy is thought to be poor histologically as indicated by this case and previously reported cases, so initial radical surgery and adjuvant procedures soon after diagnosis are necessary to achieve cure.