title: Imaging of mesothelioma of tunica vaginalis testis.
abstract: OBJECTIVE
  To describe the imaging findings in a series of patients with mesothelioma of the tunica vaginalis testis.
  
  
  METHODS
  We reviewed clinical data, imaging findings and follow-up information in a series of 10 pathology-proven cases of mesothelioma (all had US; 2 had MR) of the tunica vaginalis.
  
  
  RESULTS
  A variety of patterns could be observed, the most common (5/10) being a hydrocele with parietal, solid and hypervascular vegetations; one patient had a septated hydrocele with hypervascular walls; one had multiple, solid nodules surrounded by a small, physiological quantity of fluid; one a cystic lesion with thick walls and vegetations compressing the testis; two had a solid paratesticular mass. MR showed multiple small nodules on the surface of the tunica vaginalis in one case and diffuse thickening and vegetations in the other one; lesions had low signal intensity on T2-w images and were hypervascular after contrast injection.
  
  
  CONCLUSIONS
  A preoperative diagnosis of mesotheliomas presenting as solid paratesticular masses seems very difficult with imaging. On the contrary, the diagnosis must be considered in patients in whom a hydrocele with parietal vegetations is detected, especially if these show high vascularity.
  
  
  CONCLUSIONS
  Mesotheliomas of the tunica vaginalis are rare, often challenging to diagnose preoperatively. Most common finding is a complex hydrocele with hypervascular parietal vegetations. Septated hydrocele, nodules without hydrocele, a thick-walled paratesticular cyst are less common. Preoperative diagnosis may allow aggressive surgical approach and, possibly, a better prognosis.
authors.affiliation: Department of Radiology, University of Trieste, Trieste, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Bertolotto
authors.affiliation: Service d'Imagerie Medical, Fondation Hopital Saint Joseph, Paris, France.
authors.forename: I
authors.initials: I
authors.lastname: Boulay-Coletta
authors.affiliation: Department of Radiology, Ospedale S. Giacomo, Castelfranco Veneto, TV, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Butini
authors.affiliation: Department of Radiology, Univ. Med. Pharm. "Iuliu Hatieganu", Cluj-Napoca, Romania.
authors.forename: S M
authors.initials: SM
authors.lastname: Dudea
authors.affiliation: Department of Radiology, Pellegrin Hospital, Place Amelie Raba Leon, 33076, Bordeaux, France.
authors.forename: N
authors.initials: N
authors.lastname: Grenier
authors.affiliation: Department of Radiology, University Hospital of North Norway, Tromsø, N9038, Norway.
authors.forename: G
authors.initials: G
authors.lastname: Oltmanns
authors.affiliation: Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
authors.forename: P
authors.initials: P
authors.lastname: Ramchandani
authors.affiliation: Department of Radiology, Albert Einstein College of Medicine, Montefiore Medical Center, 111 E. 210th Street, Bronx, NY, 10467, USA.
authors.forename: M W
authors.initials: MW
authors.lastname: Stein
authors.affiliation: Department of Radiology, Sant'Antonio Hospital, Tolmezzo, UD, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Valentino
authors.affiliation: Department of Health Sciences, University of Genoa, Largo R. Benzi, 10, Genova, Italy. derchi@unige.it.|Radiologia d'Urgenza, IRCCS Azienda Ospedaliera Universitaria San Martino IST, Largo R. Benzi, 10, I-16122, Genova, Italy. derchi@unige.it.
authors.forename: Lorenzo E
authors.initials: LE
authors.lastname: Derchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008654:Mesothelioma / Q000098:blood supply / Q000175:diagnosis / Q000000981:diagnostic imaging*; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D006848:Testicular Hydrocele / Q000175:diagnosis / Q000000981:diagnostic imaging; D013736:Testicular Neoplasms / Q000098:blood supply / Q000175:diagnosis / Q000000981:diagnostic imaging*; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color / Q000379:methods
chemical_list: D003287:Contrast Media
keywords: Magnetic resonance imaging; Mesothelioma; Preoperative diagnosis; Tunica vaginalis testis; Ultrasound