Aktuelle Urologie. 2006 Jul;37(4):281-3. [Link]
Hatzinger M, Hacker A, Langbein S, Grobholz R, Alken P.
Urologische Universitatsklinik, Klinikum Mannheim gGmbH, Fakultat fur Klinische Medizin Mannheim der Ruprecht-Karls-Universitat Heidelberg.
Introduction: Malignant mesothelioma of the tunica vaginalis is a very rare malignant tumour. The prevalence of mesothelioma is about 1 : 1 000 000: Only 1 % have their origin in the tunica vaginalis testis with a 5-year survival of less than 5 %. About 80 cases have been reported in the literature. In 41 % of these cases exposure to asbestos for many years was determines.
Case Report: We report on a 76-year-old patient who presented with an atypical hydrocele testis. Intraoperatively, thickened testicular walls and an crystalline lawn adjacent to the tunica vaginalis testis were found.
Conclusions: Ultrasonography showing snow flurries together with cloudy hydrocele fluid and visible crystal particles and thickened testicular walls may help to identify a mesothelioma of the testicular walls. Intraoperative frozen section and a high inguinal orchiectomy is the operative method of choice.