Florid mesothelial hyperplasia of the tunica vaginalis: report of two cases with immunohistochemical findings

  • Daniel Abensur AthanazioEmail author
  • Andrea de Oliveira Cruz
  • Luiza Oliveira Barbosa
  • Isabela Soares Pimenta
  • Nathanael Pinheiro de FreitasJr.
Urology - Letter to the Editor


Mirroring reactive lesions in other surface membranes, mesothelial hyperplasia of the tunica vaginalis may be so florid that it can mimic malignant mesothelioma or adenocarcinoma. In the largest series reported to date (n = 12), by Epstein et al. [1], 75% of all cases are associated with hydrocele and 1 case (8%) with hematocele. Before that series, mesothelial hyperplasia of tunica vaginalis was thought to be associated more commonly with hernial sacs, while malignant mesothelioma would be more associated with hydrocele sacs [2]. Awareness of that florid reactive condition is important, since true malignant mesothelioma of tunica vaginalis is a rare tumor—0.3% to 5% of all malignant mesotheliomas, with about 100 cases reported so far [2].

Case 1: a 41-year-old patient who had a long-term history of hydrocele. At intraoperative inspection, a focal thickening of tunica vaginalis was noted (Fig.  1). Case 2: a 72-year-old patient sought medical attention due to progressive...


Mesothelial hyperplasia Testis Tunica vaginalis 


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Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  • Daniel Abensur Athanazio
    • 1
    • 2
    Email author
  • Andrea de Oliveira Cruz
    • 1
  • Luiza Oliveira Barbosa
    • 1
  • Isabela Soares Pimenta
    • 1
  • Nathanael Pinheiro de FreitasJr.
    • 1
  1. 1.Imagepat LaboratorySalvadorBrazil
  2. 2.Departamento de Patologia e Medicina Legal, Faculdade de Medicina da BahiaUniversidade Federal da BahiaSalvadorBrazil

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