Malignant mesothelioma of the tunica vaginalis: A case report and comprehensive literature review.

Malignant mesothelioma of the tunica vaginalis testis (MMTVT) is an exceedingly rare neoplasm, representing <1 % of all mesothelioma cases. We report a 64-year-old male with prolonged occupational asbestos exposure presenting with a chronic hydrocoele. Hydrocoelectomy revealed abnormal tunica vaginalis tissue, prompting radical orchiectomy. Histology confirmed MMTVT. Subsequent hemiscrotectomy with cord excision and inguinal lymph node dissection was performed and he remains disease free on follow up. Integrated with the largest body of literature available, this case highlights the need for heightened clinical suspicion in chronic hydrocoele with asbestos exposure, and the role of radical surgery as the cornerstone of treatment.