Annals of Case Reports and Clinical Studies (ISSN: 2834-5673) | Volume 5, Issue 5 | Case Report | Open Access
Anil Kumar Sah*
Harshdeep Singh1*, Aravind TK2, Siddharth Yadav3, Paridhi4, Anil Kumar Sah5
1Department of Urology, Government Medical College, Amritsar, India
2Department of Urology, Robotics and Renal Transplant, Vardhman Mahavir Medical College & Safdarjung Hospital, India
3Department of Urology, Robotics and Renal Transplant, Vardhman Mahavir Medical College & Safdarjung Hospital, India
4Senior Resident, National institute of pathology, ICMR, India
5Department of Urology and Andrology, VNA Hospital, Navajeevan Vihar, Gitanjali Enclave, India
*Correspondence to: Anil Kumar Sah
Fulltext PDFBackground: Paratesticular malignant mesothelioma is an uncommon and aggressive tumor. While most originate from the tunica vaginalis, involvement of the spermatic cord is exceedingly rare. Its nonspecific presentation and ability to mimic benign scrotal disorders often results in delayed diagnosis and advanced disease at presentation.
Case Presentation: We report a 54-year-old man with diabetes mellitus who presented with a four-year history of progressive penoscrotal swelling, initially misdiagnosed as benign conditions. Examination revealed diffuse induration involving the scrotum, penile shaft, and spermatic cords. MRI demonstrated a large infiltrative lesion, while biopsy with immunohistochemistry (WT1, calretinin positive; CK20, PAX8 negative) confirmed malignant mesothelioma. He underwent total scrotectomy, penile skin excision, and left orchidectomy with graft reconstruction. Within one month, he developed local recurrence with nodal, pulmonary, hepatic, and mediastinal metastases. Despite systemic chemotherapy and subsequent chemoradiotherapy, the disease progressed, highlighting its aggressive course and poor prognosis.
Discussion: Spermatic cord mesotheliomas are infrequently diagnosed preoperatively and often pose a diagnostic challenge due to nonspecific clinical features and overlapping differentials. Radical surgical excision remains the cornerstone of management given the aggressive biological nature of the disease; however, recurrence rates and disease-related mortality remain high, particularly in advanced stages. Multimodal adjuvant therapies provide only limited benefit but may play a supportive role, with overall prognosis remaining poor.
Conclusion: Spermatic cord mesothelioma is a rare paratesticular malignancy, often diagnosed at an advanced stage, and continues to pose a therapeutic challenge with generally unfavourable outcomes.
Mesothelioma, Paratesticular, Spermatic Cord, Case Report
Harshdeep Singh, Aravind TK, Siddharth Yadav, Paridhi, Anil Kumar Sah. Primary Spermatic Cord Mesothelioma: A Rare Case Report with Review of Literature. Ann Case Rep Clin Stud. 2026;5(5):1-8.