{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:25:18Z","timestamp":1790900718709,"version":"4.1.0"},"reference-count":31,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2024,1,2]],"date-time":"2024-01-02T00:00:00Z","timestamp":1704153600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J Surg Pathol"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:p>Malignant mesothelioma of the tunica vaginalis is an extremely rare and aggressive tumor that is frequently encountered in elderly patients. The diagnosis of malignant mesothelioma of the tunica vaginalis poses a diagnostic challenge due to its infrequency and nonspecific clinical presentation. Histopathological examination and immunohistochemical staining are essential in differentiating this tumor from other para-testicular masses and establishing a definitive diagnosis. Early detection and comprehensive treatment planning are crucial for improving the prognosis and overall outcomes for patients with this rare malignancy. We present a report of malignant mesothelioma of the tunica vaginalis in a 78-year-old male patient with no history of asbestos exposure who presented with a large infiltrative left para-testicular mass. Histopathological examination revealed a biphasic proliferation composed of epithelioid and spindle cells with infiltrative features, foci of necrosis, and increased mitotic figures. Immunohistochemical staining exhibited positive staining for WT1, D2-40, and calretinin, supporting the mesothelial origin of the tumor. Notably, BerEP4 staining was negative, arguing against carcinoma. Immunostaining for keratin 5 was positive, supporting the mesothelial differentiation. The Ki67 proliferation index was high. The differential diagnosis included adenomatoid tumors, germ cell tumors, and pleomorphic sarcoma. We aim to discuss the clinical presentation, diagnostic approach, and therapeutic approaches of this rare entity.<\/jats:p>","DOI":"10.1177\/10668969231215426","type":"journal-article","created":{"date-parts":[[2024,1,3]],"date-time":"2024-01-03T00:51:40Z","timestamp":1704243100000},"page":"1117-1122","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Malignant Para-Testicular Mesothelioma: A Rare Presentation in the Tunica Vaginalis of an Elderly Male With No Prior Asbestos Exposure"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6145-256X","authenticated-orcid":false,"given":"Nada","family":"Shaker","sequence":"first","affiliation":[{"name":"The Ohio State University Wexner Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heath","family":"Blankenship","sequence":"additional","affiliation":[{"name":"Wake Forest School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuha","family":"Shaker","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Pittsburgh Medical Center Health System"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruwaida","family":"Ben Musa","sequence":"additional","affiliation":[{"name":"Biomedical Sciences, University of Missouri-Columbia, Columbia, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1137-0237","authenticated-orcid":false,"given":"Shuo","family":"Niu","sequence":"additional","affiliation":[{"name":"Wake Forest School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaaeddin","family":"Alrohaibani","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Emory University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Mansoor","sequence":"additional","affiliation":[{"name":"Department of Pathology, International Medical Center Hospital, Al-Ruwais, Jeddah, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafat","family":"Abu Shakra","sequence":"additional","affiliation":[{"name":"Department of Pathology, International Medical Center Hospital, Al-Ruwais, Jeddah, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar P.","family":"Sangueza","sequence":"additional","affiliation":[{"name":"Wake Forest University, School of Medicine Medical Center Boulevard"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,1,2]]},"reference":[{"issue":"11","key":"e_1_3_2_2_2","first-page":"532","article-title":"An incidental finding of paratesticular malignant mesothelioma during operation for hydrocelectomy","volume":"72","author":"White KD","year":"2019","unstructured":"White KD, Bohy KC, Muirhead DM, Kerkvliet AM. 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