Malignant mesothelioma of the tunica vaginalis and epididymis

Malignant mesothelioma of the para-testis is a rare cancer which may be clinically undiagnosed for several years and found incidentally at cut up for presumed benign disease. It has a number of histological presentations to be aware of and pitfalls to avoid. It is important to be able to reliably distinguish para-testicular MM from various other less aggressive entities which have significantly different management strategies. We present a case of epididymis and tunica vaginalis MM that was incidentally diagnosed on histological examination following a hydrocelectomy.