Rare multinodular epithelioid malignant mesothelioma

Ultrasound presentation of a rare multinodular epithelioid malignant mesothelioma of the tunica vaginalis without asbestos exposure: a case report

Published on September 1, 2025

Malignant mesothelioma is a rare, aggressive cancer that affects the mesothelial cells lining the pleural, peritoneal, and pericardial cavities and the tunica vaginalis1. Mesotheliomas of the tunica vaginalis (MMTVs) account for 1–3% of all mesotheliomas and originate from mesothelial cells in this area2.

Within the scrotum, the visceral layer of the tunica vaginalis serves as the outer covering of the tunica albuginea, which encases the testes. The parietal layer of the tunica vaginalis is proximal to the scrotal wall muscles, fascia and skin3. This leaves potential space between the tunica layers to accommodate fluid build-up. Hydrocele is characterised by fluid accumulation between the visceral and parietal layers of the tunica vaginalis, leading to scrotal swelling4. This condition can arise from various aetiologies, including trauma, infection or idiopathic causes.

Ultrasound is the primary imaging modality used to assess...

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