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CASE REPORT
Primary malignant mesothelioma of the spermatic cord
  1. Zeeshan Ahmed1,
  2. Suresh Singh1,
  3. Akshay Mangal1,
  4. Alka Mittal2
  1. 1Division of Surgical Oncology, SMS Medical College and Hospital, Jaipur, Rajasthan, India
  2. 2Department of Pathology, SMS Medical College and Hospital, Jaipur, Rajasthan, India
  1. Correspondence to Dr Zeeshan Ahmed, drzeeshan180{at}gmail.com

Summary

Primary spermatic cord malignant mesothelioma is an extremely rare tumour with only 12 cases reported so far. It is an aggressive tumour with a high recurrence rate. A 45-year-old man presented with a slow growing right inguinal swelling for the past 1 year. Physical examination revealed a well-circumscribed, hard, non-reducible swelling palpable along the medial extent of the inguinal canal with no cough impulse. Fine-needle aspiration cytology suggested metastatic carcinoma. Contrast-enhanced CT of the thorax and abdomen did not reveal any primary. Right high inguinal orchidectomy was performed at another institution. Postoperative histopathological examination (HPE) and immunohistochemistry suggested biphasic malignant mesothelioma with resected margin positive. The patient was referred to us for revision surgery and adjuvant therapy. Postoperative course was uneventful. Currently, he is undergoing radiotherapy.

Surgery is the first-line treatment. Patients should receive adjuvant radiotherapy and/or chemotherapy and long-term follow-up surveillance.

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