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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. [ABSTRACT FROM AUTHOR]

Scrotal malignant mesothelioma is an aggressive tumor arising from the tunica vaginalis. Due to its rarity, this tumor is often accidentally found during histological evaluation and there are no recommendations for treatment. Based on three case presentations we try to draw attention for this rare disease and highlight the importance of referring these patients to a tertiary center. [ABSTRACT FROM AUTHOR]

Pediatric surgeons have faced esophageal reconstruction challenges for decades owing to a variety of congenital and acquired conditions. This work aimed to introduce a reproducible and efficient approach for creating tissue-engineered esophageal tissue using bone marrow mesenchymal stem cells (BMSCs) cultured in preconditioned mediums seeded on a sheep decellularized tunica vaginalis (DTV) scaffold for partial reconstruction of a rabbit's esophagus. DTV was performed using SDS and Triton X-100 solutions. The decellularized grafts were employed alone (DTV group) or after recellularization with BMSCs cultured for 10 days in preconditioned mediums (RTV group) for reconstructing a 3 cm segmental defect in the cervical esophagus of rabbits (n = 20) after the decellularization process was confirmed. Rabbits were observed for one month, after which they were euthanized, and the reconstructed esophagi were harvested for histological analysis. Six rabbits in the DTV group and eight rabbits in the RTV group survived until the end of the one-month study period. Despite histological examination demonstrating that both grafts completely repaired the esophageal defect, the RTV graft demonstrated a histological structure similar to that of the normal esophagus. The reconstructed esophagi in the RTV group revealed the arrangement of the different layers of the esophageal wall with the formation of newly formed blood vessels and Schwann-like cells. DTV xenograft is a novel scaffold that promotes cell adhesion and differentiation and might be effectively utilized for regenerating esophageal tissue, paving the way for future clinical trials in pediatric patients. [ABSTRACT FROM AUTHOR]

Objective To explore the surgical techniques and experiences in the treatment of Peyronie's disease using electric rotary grinding of tunica albuginea plaques followed by graft repair with tunica vaginalis or bovine pericardium under a microscope. Methods A retrospective cohort study was performed on 21 patients with severe penile curvature due to Peyronie's disease admitted in our department from January 2021 and May 2023. All of them underwent microscopic electric rotary grinding of tunica albuginea plaques followed by graft repair surgery. Short-term and mid-term outcomes were observed. Results For the 21 enrolled patients, 12 (57.1%) underwent repair using unilateral tunica vaginalis, 3 (14.3%) underwent repair using bilateral tunica vaginalis, and 6 (28.6%) underwent repair using bovine pericardium. The operation time was 170~385 (average 272±69) min, and the average postoperative follow-up duration was 3~24 (average 12.1±7.2) months. Seventeen patients (81.0%) had their penis fully extended, while 4 patients (19.0%) had slight dorsal curvature, which was less than 10°. All patients were satisfied with the shape of their penis during erection. The change in penile length was +(1.1±0.5) cm, and 9 patients (42.9%) reported early postoperative penile head numbness, which spontaneously resolved after an average duration of 3.2±1.9 months. All patients were able to successfully engage in sexual activity, with an average penile erection hardness score of 3.8. The overall satisfaction rate was 90.5% postoperatively. Conclusion Meticulous dissection of Buck's fascia under a microscope is advantageous in reliably preserving dorsal neurovascular structures. Application of an electric grinding drill for plaque ablation allows for more precise release of the tunica. Graft repair of tunica albuginea defects with testicular tunica vaginalis or bovine pericardium for Peyronie's disease yields overall favorable clinical outcomes and obtains high satisfaction. It is worthy of promotion in clinical practice.

Abstract Mesothelioma is a rare cancer that generally affects the lining of the lungs. However, in more rare cases, there are extra-pleural involvement of organs that are lined with mesothelial cells, including the testicle. Mesothelioma of the tunica vaginalis of the testicle typically presents with a painless scrotal mass with accompanying hydrocele of the affected side. The most common predisposition to mesothelioma of the tunica vaginalis is previous asbestos exposure, long-standing hydrocele, and previous scrotal surgeries. In this case we present a patient with isolated left tunica vaginalis mesothelioma of the testicle, yet without classic risk factors or other sites of disease. Left radical orchiectomy was performed and subsequent follow-up imaging did not reveal any sites of recurrence or metastasis. Although, mesothelioma of the tunica vaginalis is a rare cancer, it should be seen as a possible differential when evaluating new testicular masses.

Pananterior urethral stricture involving the penile and bulbar urethra is a challenging urological condition in the Indian population. In India, Balanitis Xerotica Obliterans (BXO) or Lichen Sclerosus (LS) is the most common cause of pananterior urethral stricture. Various surgical techniques have been described in the literature for present condition, with varied outcomes. However, there is still a need for a simple and effective procedure to address this problem. Hereby, the authors present a case series that included five male patients with BXO and pananterior urethral stricture who underwent Detubularised Non Augmented (DNA) urethroplasty between January 2022 and December 2022. The median age of the patients was 45 years, with a mean stricture length of 13 cm. The median follow-up period was 11 months. During the procedure, a scroto-perineal incision was made, and the anterior urethra was ventrally cut open from the meatus to the junction of the stricturous and normal urethra. A right-sided Tunica Vaginalis (TV) flap was raised (left is left), and the cut-open anterior urethra was wrapped with the TV flap, creating a “controlled fistula” at the proximal end of the detubularised urethra. The average operative time was 1.5 hours. The success of the procedure was determined by a postoperative peak flow rate of 12 mL/sec or more, with no further need for urethral dilatation or direct vision internal urethrotomy. The procedure was successful in 4 out of 5 cases (80%). One patient developed a narrowed urethra during follow-up and required serial catheter upgradation for urethral dilatation. In conclusion, DNA urethroplasty was found to be a simple and effective treatment option for the notorious pananterior urethral stricture associated with BXO.

Introduction: Malignant mesothelioma (MM) of tunica vaginalis is a very rare tumor and it has a poor prognosis. It is not easy to diagnose the disease preoperatively because there is a lack of comprehensive studies and information about the disease. We would like to present our two cases with severe scrotal edema and hydrocele, which were debrided perioperatively due to scrotal necrosis, followed by radical inguinal orchiectomy and subsequently diagnosed as MM of tunica vaginalis. Case 1: A 74-year-old male patient with bilateral scrotal swelling for 6 months. Right radical inguinal orchiectomy was performed. The pathology result of right radical inguinal orchiectomy material was compatible with malignant mesothelioma of tunica vaginalis. Case 2: A 90-year-old male patient with complaints of right scrotal swelling for 3 years. A right radical inguinal orchiectomy was performed. The pathology result of right radical inguinal orchiectomy material was compatible with malignant mesothelioma of tunica vaginalis. Conclusion and discussion: MM has a very poor prognosis therefore early treatment plan should be made. Surgery is the main treatment for malignant mesothelioma of the testis. Although chemotherapy and radiotherapy play an active role in the treatment of metastatic disease, surgery is the first-line therapy in the treatment of the tumor. Also; long-term hydrocele, recurrent epididymitis, scrotal edema can make it harder to detect the tumor diagnosis. MM should be considered in such patients. Necrosis and abscess appearance was not mentioned before in published case reports. In this respect, it should not be ignored the long-term hydrocele situation and the appearance of abscess-epididymitis that cannot be treated properly. [ABSTRACT FROM AUTHOR]

Background: Peyronie's disease (PD) is a progressive disorder of the connective tissue of the tunica albuginea of the penis that produces an abnormal curvature, painful erections and different degrees of erectile dysfunction (ED). The aim of this study is to evaluate our initial experience in the surgical treatment of PD using an autologous graft of testicular vaginal tunica. Materials and methods: A retrospective study of 23 patients was carried out between 2015 and 2019. The successful surgical stretching rate was defined as a functional 20 degrees of curvature or less. Postoperative sexual function and complications rate were evaluated as secondary objectives. We used the abbreviated IIEF-5 questionnaire and evaluated the sexual function before and after the surgical procedure. Wilcoxon signed-rank test for paired samples (U test) was used, considering a value of p <0.05 to be statistically significant. Results: Only one patient presented a recurrence of the penile curvature, resulting in a 95.6% success rate of functional stretching. We observed a 1.6 and 0.9 difference between pre- and postoperative total score and satisfaction (p = 0.002 and p = 0.003 respectively) Conclusion: In this series, the use of testicular vaginal tunic was found to be safe and effective with a significant change in the quality of sexual life, especially reflected in the overall satisfaction after the procedure and a low rate of complications. Level of evidence: Not applicable for this multicentre audit. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Adenomatoid tumor is a kind of benign tumor, accounts for a low percentage of scrotal tumors. It usually locates in epididymis, less commonly, arises from the tunica albuginea, spermatic cord or tunica vaginalis of male's urogenital tract system. Here, we report a case of a 32-year-old male, which presented as a 6-month history of left scrotal swelling pain with a scrotal mass, and it had progressively enlarged over the last 1 month. The ultrasonography (US) described a giant well-defined hypoechoic mass in the left scrotum, a thick pedicle connected the mass and the left scrotal wall, and the pedicle had large blood vessels in it. Enhanced CT showed an irregular solid mass in the left scrotum, the left testicular artery was thickened to supply blood for the mass, and the radiologist mentioned it could not be excluded as a malignant lesion. The patient underwent left radical orchiectomy, the mass was diagnosed as an adenomatoid tumor of the tunica vaginalis by pathology. We review literature regarding adenomatoid tumors originating in the tunica vaginalis, summarize the ultrasonographic presentations, provide the idea of diagnosis and differential diagnosis to improve diagnostic accuracy and avoid unnecessary orchiectomy.

In veterinary clinics, esophageal reconstruction is essential in many clinical situations. In this study, two autografts, the tunica vaginalis (TV) and the buccal mucosa (BM), were proposed to reconstruct a semi-circumferential cervical esophageal defect in dogs. This study aimed to verify whether these two grafts could successfully patch esophageal defects. Twelve male mongrel dogs were divided into two groups. Following cervical esophagoplasty, the defective area was patched with either a TV or a BM graft. Comprehensive clinical, serum biochemical, and histological analyses were performed to evaluate the two grafts. Throughout the study (120 days), the dogs survived the procedure well with minor complications. The lumen of the patched areas was covered with mucosa, with slight scar retraction. Compared with that of the natural esophagus, the average relative luminal diameter was not significantly decreased. Importantly, the measured cortisol and inflammatory marker levels returned to the preoperative levels after 14 days. Although histological examination revealed that both grafts repaired the esophageal defect with complete re-epithelialization, the BM graft showed a histological structure similar to that of the natural esophagus. Both grafts effectively repaired the esophageal defect with minor complications; therefore, both are recommended as promising low-cost clinical alternatives for cervical esophagoplasty in dogs. [ABSTRACT FROM AUTHOR]

Pananterior urethral stricture involving the penile and bulbar urethra is a challenging urological condition in the Indian population. In India, Balanitis Xerotica Obliterans (BXO) or Lichen Sclerosus (LS) is the most common cause of pananterior urethral stricture. Various surgical techniques have been described in the literature for present condition, with varied outcomes. However, there is still a need for a simple and effective procedure to address this problem. Hereby, the authors present a case series that included five male patients with BXO and pananterior urethral stricture who underwent Detubularised Non Augmented (DNA) urethroplasty between January 2022 and December 2022. The median age of the patients was 45 years, with a mean stricture length of 13 cm. The median follow-up period was 11 months. During the procedure, a scroto-perineal incision was made, and the anterior urethra was ventrally cut open from the meatus to the junction of the stricturous and normal urethra. A right-sided Tunica Vaginalis (TV) flap was raised (left is left), and the cut-open anterior urethra was wrapped with the TV flap, creating a "controlled fistula" at the proximal end of the detubularised urethra. The average operative time was 1.5 hours. The success of the procedure was determined by a postoperative peak flow rate of 12 mL/sec or more, with no further need for urethral dilatation or direct vision internal urethrotomy. The procedure was successful in 4 out of 5 cases (80%). One patient developed a narrowed urethra during follow-up and required serial catheter upgradation for urethral dilatation. In conclusion, DNA urethroplasty was found to be a simple and effective treatment option for the notorious pananterior urethral stricture associated with BXO. [ABSTRACT FROM AUTHOR]

Urethral cutaneous fistulas are rarely reported in dogs. Several techniques have been described to treat urethrocutaneous fistulas with different degrees of success. This case report is on a four-year-old male intact German shepherd diagnosed with urethrocutaneous fistulas after two weeks of dysuria. The urethra was repaired using an autologous tunica vaginalis pedicle flap after open castration and scrotal ablation. The dog was catheterised for two weeks after which a positive contrast urethrogram revealed a healed urethra with no stricture or leakage into surrounding tissue. The dog was discharged the following day after normal urination. Follow-up examination with the referring veterinarian at five months confirmed that the dog was clinically healthy and urinating normally. Literature about urethrocutaneous fistulas is lacking in the small animal field. To our knowledge there are no reports in the literature describing the use of an autologous tunica vaginalis pedicle flap for the repair of a urethral defect in dogs. This case report describes a novel technique to treat urethrocutaneous fistulas in an intact male dog. [ABSTRACT FROM AUTHOR]

Background: Two stage urethroplasty for proximal penile hypospadias is time consuming, expensive and; traumatic both for parents and phallus. On the other hand, single stage procedure technically demanding. We would like to describe Extended Ulaanbaatar Procedure (EUP) which is not a two stage procedure. Rather, might be called as 'extended single stage' procedure. In EUP we have done orthoplasty along with urethroplasty with preputial skin graft at same sitting as primary procedure keeping urination diverted through proximal hypospadiac meatus as "controlled fistula" which was closed after six months as secondary procedure. Methods: We operated on 35 patients of proximal penile hypospadias with moderate to severe chordee. Chordee was excised till correction of curvature. Two distracted cut ends of native plate was bridged with preputial skin graft (PSG) in between. Following that, silastic tube was placed over glandular plate as scaffold, on both cut ends of native plate and PSG. All the urethral plates and PSG were buried with tunica vaginalis flap before glanuloplasty. After six months, proximal "controlled fistula" was closed with scrotal dartos fascia and skin to join distal to proximal urethra. Results: Vertical meatus in glans was found in 32 patients. One patient had glans dehiscence, two patients had medium sized fistula, another two patients had stenosis in neourethra and six had suture track fistula. Twenty-nine patients had satisfactory curve with good flow in uroflowmetry as per nomogram at sixth month of follow up. Conclusion: In classic Ulaanbaatar procedure authors do distal urethroplasty and glanuloplsaty in 1st stage following orthoplasty to avoid repeat trauma in glans in repeat procedures. Left over urethroplasty in classic Ulaanbaatar was done in 2nd stage. However, in EUP; we did urethroplasty for full length following orthoplasty as primary procedure. This procedure is less invasive than two staged as we avoided repeat degloving and repeat dissection on operated tissues. Urethroplasty done as primary procedure shunned the need of repeat degloving, decreased the period of morbidity, stay, and cost of surgery. We also avoided problems of urination through not matured, long, neo-urethra. Similarly complications i.e disruption, stenosis in neo-urethra can be managed utilizing the advantages of urinary diversion. [ABSTRACT FROM AUTHOR]

Background: Two stage urethroplasty for proximal penile hypospadias is time consuming, expensive and; traumatic both for parents and phallus. On the other hand, single stage procedure technically demanding. We would like to describe Extended Ulaanbaatar Procedure (EUP) which is not a two stage procedure. Rather, might be called as 'extended single stage' procedure. In EUP we have done orthoplasty along with urethroplasty with preputial skin graft at same sitting as primary procedure keeping urination diverted through proximal hypospadiac meatus as “controlled fistula” which was closed after six months as secondary procedure. Methods: We operated on 35 patients of proximal penile hypospadias with moderate to severe chordee. Chordee was excised till correction of curvature. Two distracted cut ends of native plate was bridged with preputial skin graft (PSG) in between. Following that, silastic tube was placed over glandular plate as scaffold, on both cut ends of native plate and PSG. All the urethral plates and PSG were buried with tunica vaginalis flap before glanuloplasty. After six months, proximal “controlled fistula” was closed with scrotal dartos fascia and skin to join distal to proximal urethra. Results: Vertical meatus in glans was found in 32 patients. One patient had glans dehiscence, two patients had medium sized fistula, another two patients had stenosis in neourethra and six had suture track fistula. Twenty-nine patients had satisfactory curve with good flow in uroflowmetry as per nomogram at sixth month of follow up. Conclusion: In classic Ulaanbaatar procedure authors do distal urethroplasty and glanuloplsaty in 1st stage following orthoplasty to avoid repeat trauma in glans in repeat procedures. Left over urethroplasty in classic Ulaanbaatar was done in 2nd stage. However, in EUP; we did urethroplasty for full length following orthoplasty as primary procedure. This procedure is less invasive than two staged as we avoided repeat degloving and repeat dissection on operated tissues. Urethroplasty done as primary procedure shunned the need of repeat degloving, decreased the period of morbidity, stay, and cost of surgery. We also avoided problems of urination through not matured, long, neo-urethra. Similarly complications i.e disruption, stenosis in neo-urethra can be managed utilizing the advantages of urinary diversion.

Dirofilaria repens (Spirurida: Onchocercidae) is the causative agent of canine subcutaneous dirofilariosis. Adults of D. repens localize in the subcutaneous tissues and fasciae and most of the infected animals are asymptomatic though dermatological disorders have been described sporadically. In this study, the gonads of 100 male dogs were inspected for D. repens presence from December 2020 to January 2022. All examined dogs were older than 48 months and underwent castration for several reasons. The testes and the superficial layers were examined with the aid of stereomicroscope; in addition, the blood of all included dogs was collected and analysed by Knott's test to assess the presence of microfilariae. Six out of 100 (6 %, CI95%, 2.2-12.6 %) examined dogs were positive for D. repens presence, and in all the cases the parasites were found beneath the tunica vaginalis layers. Microfilariae were found in 15 blood samples including 5 out of those 6 testes positive dogs thus resulting in a final D. repens prevalence of 16 % (CI95%: 9.4-24.7 %). No pathological changes and or lesions due to parasite presence were observed in the testes or in their layers. The present study represents the first survey focusing on the detection of D. repens in dog testes on a large sample size. Adult parasites were found in the testes of 6 out of 16 D. repens infected dogs accounting for 37.5 % of cases and suggesting as testicular localization is not uncommon. The absence of neoplastic or inflammatory lesions in D. repens infected testes suggests as these conditions do not act as attractive stimuli for the parasite localization. Finally, considering the zoonotic potential of D. repens and the large infection prevalence here reported, active surveillance in endemic areas is strongly advocated to limit the presence of reservoir and prevent further infections to animals and humans., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Malignant mesothelioma (MM) of the tunica vaginalis is an exceedingly rare neoplasm, with fewer than 300 cases reported in the medical literature. Due to its rarity, epidemiology, and risk factors are still unclear, and it is unknown whether asbestos or chronic inflammatory conditions play a role in etiology. This case study presents a 70-year-old male patient with MM of the tunica vaginalis, detailing the diagnostic challenges, treatment procedures, and eventual progression to palliative care. The study underscores the importance of accurate diagnosis and the aggressive nature of the disease despite treatment efforts., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Guerra et al.)

The mesothelium, which consists of a monolayer of mesothelial cells, extends over the surface of the serosal cavities (pleura, pericardium, peritoneum and tunica vaginalis). Mesothelial tumours of the tunica vaginalis is rare compared with those arise from pleura or peritoneum. According to World Health Organization 2022 Classification of Urinary and Male Genital Tumours (5th edition), mesothelial tumours of the tunica vaginalis were categorized into adenomatoid tumour, well-differentiated papillary mesothelial tumour (WDPMT) and mesothelioma. Since WDPMT of tunica vaginalis was rare, there was no consensus concerning the treatment of it. In this case report, a 29-year-old man who had endured intermittent right scrotal pain for 8 months, aggravating scrotal pain for 2 weeks was admitted. No symptoms, such as frequent, urgent, or painful urination were shown. Physical examination revealed the enlargement and tenderness of right scrotum, with no signs of lifting pain. The most recent scrotal ultrasonography before surgery revealed right hydrocele with maximum depth of 4 centimeters and poor blood flow of right testis. Under the circumstance of patient' s chronic history of testicular hydrocele, he underwent an emergency operation of right scrotal exploration and hydrocelectomy under epidural anesthesia. After opening the vagina tunic cavity, spot-like bleeding was observed on the right testicle, epididymis and vaginalis surface. The vaginalis was obviously thickened and the inner and outer walls were smooth. The post-operative histopathology revealed a grayish-brown tissue with a thickness of 0.3-0.5 cm, smooth inner and outer walls, and a suspected WDPMT with a diameter of 1. 5 cm. Immunohistochemical staining showed positive for Calretinin, BAP1, WT-1, CK5/6, D2-40 and P16，which confirmed the diagnosis of WDPMT. To sum up, the purpose of this case report was to raise awareness of a rare disease WDPMT, which was usually asymptomatic and could be diagnosed by pathology and immunohistochemistry. The disease should be differentiated from testicular torsion, epididymitis, orchitis and oblique inguinal hernia in symptoms, and from malignant mesothelioma and adenomatoid tumour in pathology. Because of the rarity of the cases, there was no unified standard for the treatment of WDPMT at present. The common treatment methods reported in literature included orchidectomy and vaginectomy. Due to the lack of understanding of this disease, postoperative follow-up was still recommended for at least 5 years.

Aims: Malignant mesothelioma (MM) of the tunica vaginalis (TV) is a rare and aggressive tumour, and the molecular features and staining profile with contemporary immunohistochemical (IHC) biomarkers are largely unexplored. We characterise the clinicopathological, molecular and IHC features of MM (n = 13) and mesothelial neoplasms of uncertain malignant potential (MUMP) (n = 4). Methods and results: Targeted next‐generation sequencing was performed on seven MMs and two MUMPs. IHC was performed for methylthioadenosine phosphorylase (MTAP), BRCA1‐associated protein 1 (BAP1) and SRY‐box transcription factor 6 (SOX6). Thirteen adenomatoid tumours were also assessed with SOX6. MM were epithelioid (seven of 13) or biphasic (six of 13). In MM, NF2 (five of seven; 71%), CDKN2A (three of seven; 43%) and BAP1 (two of seven; 29%) were most frequently altered. Non‐recurrent driver events were identified in PTCH1 and TSC1. In contrast, none of these alterations were identified in MUMPs; however, one MUMP harboured a TRAF7 missense mutation. By IHC, loss of MTAP (two of 12; 17%) and BAP1 (two of nine; 22%) was infrequent in MM, whereas both were retained in the MUMPs. SOX6 was positive in nine of 11 (82%) MMs and negative in all MUMPs and adenomatoid tumours. Conclusions: Testicular MM exhibit a similar mutational profile to those of the pleura/peritoneum; however, alterations in CDKN2A and BAP1 are less common. These findings suggest that although MTAP and BAP1 IHC are specific for MM, their sensitivity in testicular MMs appears lower. In addition, rare tumours may harbour targetable alterations in driver genes (PTCH1 and TSC1) that are unusual in MMs at other anatomical sites. SOX6 is sensitive for MM; accordingly, the presence of SOX6 expression argues against a benign neoplastic process. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to explore the clinical characteristics, treatment methods, and prognosis of neonatal pyocele of tunica vaginalis and to provide a reference for the clinical treatment. Methods: A total of 56 newborns with pyocele of tunica vaginalis were admitted to our hospital due to the scrotal emergency from January 2015 to January 2020. Our study retrospectively analyzed these 56 cases. Of the 56 cases, including 32 full-term infants and 24 premature infants, age ranged from 1 to 27 days. Initially, conservative treatment (intravenous antibiotic treatment) was applied to 42 cases, and surgery to 14 cases. Then, 7 underwent surgical exploration during the conservative treatment, and 2 cases with initial surgical treatment experienced orchiectomy because of complete necrosis. For 56 cases, the average follow-up time was 18 months. Results: The clinical recovery time of cases with conservative treatment ranged from 8 to 17 days, with an average of 11.02 ± 2.31 days. The clinical recovery time of cases with surgery ranged from 6 to 15 days, with an average of 9.28 ± 2.78 days. During the follow-up, for 56 cases, except for the 2 cases with orchiectomy, the testicular position and Doppler flow both went back to normal, of the 42 cases with initial conservative treatment, 1 case experienced testicular retardation, of the 14 cases with initial surgical treatment, 2 cases experienced testicular retardation, and hydrocele of 42 cases were self-healed. Conclusions: Neonatal pyocele of tunica vaginalis is mostly secondary to intra-abdominal infection. Color Doppler ultrasound is helpful for the diagnosis. The percutaneous aspiration is a way of collecting pathogenic bacteria during the conservative treatment. If the color Doppler suggests testicular involvement, surgical exploration should be performed. [ABSTRACT FROM AUTHOR]

Aims: Malignant mesothelioma (MM) of the tunica vaginalis (TV) is a rare and aggressive tumour, and the molecular features and staining profile with contemporary immunohistochemical (IHC) biomarkers are largely unexplored. We characterise the clinicopathological, molecular and IHC features of MM (n = 13) and mesothelial neoplasms of uncertain malignant potential (MUMP) (n = 4). Methods and results: Targeted next‐generation sequencing was performed on seven MMs and two MUMPs. IHC was performed for methylthioadenosine phosphorylase (MTAP), BRCA1‐associated protein 1 (BAP1) and SRY‐box transcription factor 6 (SOX6). Thirteen adenomatoid tumours were also assessed with SOX6. MM were epithelioid (seven of 13) or biphasic (six of 13). In MM, NF2 (five of seven; 71%), CDKN2A (three of seven; 43%) and BAP1 (two of seven; 29%) were most frequently altered. Non‐recurrent driver events were identified in PTCH1 and TSC1. In contrast, none of these alterations were identified in MUMPs; however, one MUMP harboured a TRAF7 missense mutation. By IHC, loss of MTAP (two of 12; 17%) and BAP1 (two of nine; 22%) was infrequent in MM, whereas both were retained in the MUMPs. SOX6 was positive in nine of 11 (82%) MMs and negative in all MUMPs and adenomatoid tumours. Conclusions: Testicular MM exhibit a similar mutational profile to those of the pleura/peritoneum; however, alterations in CDKN2A and BAP1 are less common. These findings suggest that although MTAP and BAP1 IHC are specific for MM, their sensitivity in testicular MMs appears lower. In addition, rare tumours may harbour targetable alterations in driver genes (PTCH1 and TSC1) that are unusual in MMs at other anatomical sites. SOX6 is sensitive for MM; accordingly, the presence of SOX6 expression argues against a benign neoplastic process. [ABSTRACT FROM AUTHOR]

Background: Peyronie's disease (PD) is a two-phase progressive condition characterized by inelastic plaques in the tunica albuginea of the penis, leading to curvature of the penis. Men with PD also suffer from psychological distress, and sexual life and overall quality of life. Although the preferred surgical treatment modality in Peyronie's disease is plaque incision and grafting, there is lack of studies assessing the erectile function and penile vasculature after the treatment. Objectives: We aimed to evaluate the efficiency and safety of plaque incision and tunica vaginalis of testis grafting in PD. Methods: This was a prospective analysis. Erectile dysfunction was assessed via International Index of Erectile Function Questionnaire (IIEF-5). Penile Doppler ultrasound was performed to assess peak systolic velocity (PSV) and end-diastolic velocity (EDV). Postoperative follow-ups were scheduled at 3, 12, and 24 months. Results: Twenty patients (mean age 47.2 ± 10.8 years) were included. The mean preoperative penile curvature was 48 ± 6.6°. The technical success rate was 100% at 3 months and 90% at 24 months. At follow-up visits, mean erect penile length was no different from the baseline. The baseline mean IIEF-5 score was 18.4 ± 2.5. The mean IIEF-5 score was 20.6 ± 2.6 at 24-month visit (p < 0.0001). Mean PSV significantly increased, while EDV significantly reduced after surgery. There were no serious complications related to surgery. Conclusions: We conclude that surgical reconstruction of penile curvature with tunica vaginalis grafting was a safe and effective procedure in PD. [ABSTRACT FROM AUTHOR]

Abstract Background Cryptorchidism in dogs is of clinical concern due to its association with development of Sertoli cell tumours, seminomas and spermatic cord torsion. A patent inguinal ring has been found as a risk factor for peritoneal content migration and inguinal hernias. This study reports a case of bowel migration through a patent inguinal ring in a bilaterally cryptorchid dog and incarceration within the vaginal tunic of the left testicle. Case presentation A three-and-a-half-year-old bilaterally cryptorchid Lhasa Apso with a history of anorexia, vomiting, stranguria and inability to defecate was diagnosed with bowel incarceration in the vaginal tunic of a retained left testicle. Surgery performed under epidural anaesthesia with acepromazine/butorphanol premedication revealed a loop of the colon entrapped in the vaginal tunic of the retained left testicle. The incarcerated bowel was thoroughly examined for viability and repositioned into the abdominal cavity. The inguinal ring was repaired and bilateral cryptorchidectomy performed. Conclusion Cryptorchidectomy in dogs is often considered when there is concern for neoplasm or torsion of retained testes. However, this report suggests that cryptorchidectomy should be considered also to preclude the possibility of bowel obstructive emergencies.

Background: In the tubularized incised plate (TIP) procedure, flap interposition between the skin and neourethra is highly recommended to decrease the postoperative fistula rate. However, there is no consensus regarding the ideal flap for this procedure. This study aimed to report our experiences in the one-stage TIP hypospadias surgery utilizing dartos flap (DF) (penile skin subcutaneous tissue) and tunica vaginalis flap (TVF) (parietal layer of the testis) as a tissue coverage of neourethra. Methods: In a retrospective study from Sep 2018 to May 2021, 16 cases of hypospadias with different types, ranging from midpenile to penoscrotal types, were managed with TIP urethroplasty using DF or TVF as a tissue coverage of neourethra were enrolled. The demographic characteristics of the participants, type of hypospadias, outcome, and complications were analyzed and compared. Results: We used TVF and DF as soft tissue coverage in 11 (68.8%) and 5 (31.3%) patients, respectively. The mean age was 56.38 ± 47.83 months. Mid-penile, proximal, and penoscrotal hypospadias were presented in 3 (18.8%), 8 (50.0%), and 5(31.2%) patients, respectively. The total success rate was 14 (87.5%), while 2 (12.5%) patients developed a urethrocutaneous fistula, which required delayed closure later. In comparison between TVF and DF groups: the TVF was applied in all patients with moderate and severe chordee and all patients with penoscrotal hypospadias, and six patients with proximal hypospadias, while only three patients with mild chordee and two patients with proximal hypospadias used the DF and showed statistical significance between groups (p < 0.001 and 0.012) respectively. The success rate was 90.9% vs. 80.0% in TVF and DF groups, respectively, with no statistical significance between groups (p = 1.000). Conclusions: In the primary TIP repair, the TVF is a practical option as a DF for the interposition cover of a neourethra, especially in penoscrotal and proximal hypospadias with severe chordee.

In veterinary practice, numerous urological disorders that cause bladder dysfunction necessitate augmentation cystoplasty (AC). The purpose of this study is to evaluate the dog tunica vaginalis allograft (DTVA), sheep tunica vaginalis xenograft (STVX) and sheep tunica vaginalis decellularized extracellular matrix (STVDEM) as graft materials for urinary bladder (UB) reconstruction following a 45±5% cystectomy model in dogs. In this study, 18 adult apparently healthy mongrel dogs of both sexes were divided into three groups (6 dogs each): the DTVA group, the STVX group, and the STVDEM group. The evaluation of the AC in different groups was carried out using clinical, hematological, serum biochemical, urine, ultrasonographic, retrograde positive cystogram, and histopathological analysis all over the study period of 12 weeks. The dogs in all groups survived the procedures, except three dogs died from both STVX and DTVA groups. The mean bladder capacity indicated that the DTVA and STVX groups had regained 82.22% and 68.62%, respectively, of their preoperative baseline capacity. Interestingly, the STVDEM group's bladder capacity increased to 113.70%. Although histological analysis revealed that the three grafts successfully rebuilt the bladder wall, the STVDEM demonstrated well-organized and well-differentiated epithelial and muscular tissues that resembled, but were not identical to, native UB tissues. As a result, STVDEM is proposed as an ideal and potential acellular graft for UB reconstruction in dogs, whereas DTVA and STVX could be employed in emergencies requiring UB reconstruction.

Background: In the tubularized incised plate (TIP) procedure, flap interposition between the skin and neourethra is highly recommended to decrease the postoperative fistula rate. However, there is no consensus regarding the ideal flap for this procedure. This study aimed to report our experiences in the one-stage TIP hypospadias surgery utilizing dartos flap (DF) (penile skin subcutaneous tissue) and tunica vaginalis flap (TVF) (parietal layer of the testis) as a tissue coverage of neourethra. Methods: In a retrospective study from Sep 2018 to May 2021, 16 cases of hypospadias with different types, ranging from midpenile to penoscrotal types, were managed with TIP urethroplasty using DF or TVF as a tissue coverage of neourethra were enrolled. The demographic characteristics of the participants, type of hypospadias, outcome, and complications were analyzed and compared. Result: We used TVF and DF as soft tissue coverage in 11 (68.8%) and 5 (31.3%) patients, respectively. The mean age was 56.38 ± 47.83 months. Mid-penile, proximal, and penoscrotal hypospadias were presented in 3 (18.8%), 8 (50.0%), and 5(31.2%) patients, respectively. The total success rate was 14 (87.5%), while 2 (12.5%) patients developed a urethrocutaneous fistula, which required delayed closure later. In comparison between TVF and DF groups: the TVF was applied in all patients with moderate and severe chordee and all patients with penoscrotal hypospadias, and six patients with proximal hypospadias, while only three patients with mild chordee and two patients with proximal hypospadias used the DF and showed statistical significance between groups (p < 0.001 and 0.012) respectively. The success rate was 90.9% vs. 80.0% in TVF and DF groups, respectively, with no statistical significance between groups (p = 1.000). Conclusions: In the primary TIP repair, the TVF is a practical option as a DF for the interposition cover of a neourethra, especially in penoscrotal and proximal hypospadias with severe chordee. [ABSTRACT FROM AUTHOR]

Background: Tunica vaginalis (TV) flap has been used by many surgeons as a waterproof layer to cover neourethra. We present our experience in using free TV graft as an alternative to TV flap for providing waterproof cover in second-stage hypospadias repair. Materials and Methods: A retrospective review of ten patients with severe hypospadias who underwent Stage II hypospadias repair over a period of 15 months was carried out. Free TV graft was used to cover neourethra in all the patients. Results: The median age of patients was 3.5 years. Six patients had proximal hypospadias with severe chordee and four patients had peno-scrotal hypospadias. Eight patients had undergone Byars procedure and two patients had undergone Bracka's procedure during the first stage repair in the same institute. The mean operative time for Stage II repair using free TV graft was 150 min (standard deviation ± 15 min). All patients passed urine in good stream following stent/feeding tube removal. The average duration of hospital stay was 11 days. None of our patients developed urethrocutaneous fistula. Only one patient had superficial surgical site infection. All patients are well on follow-up after 6 months. Conclusion: Free TV graft could be used in place of TV flap as an intermediate waterproof cover to reduce the incidence of urethrocutaneous fistula in staged II hypospadias repair; however, studies involving a larger number of patients would be required to draw conclusions.

Abstract Background Malignant mesothelioma of the tunica vaginalis is a rare tumour which comprises less than 1% of all mesotheliomas. Case presentation 69-years old patient with painful hard mass and hydrocele in the right scrotum to whom a right hydrocelectomy was performed. Any history of scrotal trauma or exposure to asbestos was not present. Excisional biopsy revealed a multinodular tumour with focal areas of necrosis and infiltrative growth. According to morphological and immunohistochemical findings, diagnosis of malignant biphasic mesothelioma of the tunica vaginalis testis was made. Two months after hydrocelectomy, right inguinal orchidectomy was performed. Post-surgical whole body CT scan revealed paraaortic and pararenal lymphadenopathy, likely to be metastatic. Adjuvant treatment with 6 cycles of cisplatin and pemetrexed was applied. After 3 cycles of chemotherapy, CT scan showed progression and the treatment was changed to gemcitabine 1 month after. Conclusions Although malignant mesothelioma of the tunica vaginalis is a rare malignancy, it poses a diagnostic challenge which can mimic common inguinal or scrotal diseases such as hydrocele. Despite aggressive surgical procedures or adjuvant therapies, the prognosis remains poor.

Background: Cryptorchidism in dogs is of clinical concern due to its association with development of Sertoli cell tumours, seminomas and spermatic cord torsion. A patent inguinal ring has been found as a risk factor for peritoneal content migration and inguinal hernias. This study reports a case of bowel migration through a patent inguinal ring in a bilaterally cryptorchid dog and incarceration within the vaginal tunic of the left testicle. Case presentation: A three-and-a-half-year-old bilaterally cryptorchid Lhasa Apso with a history of anorexia, vomiting, stranguria and inability to defecate was diagnosed with bowel incarceration in the vaginal tunic of a retained left testicle. Surgery performed under epidural anaesthesia with acepromazine/butorphanol premedication revealed a loop of the colon entrapped in the vaginal tunic of the retained left testicle. The incarcerated bowel was thoroughly examined for viability and repositioned into the abdominal cavity. The inguinal ring was repaired and bilateral cryptorchidectomy performed. Conclusion: Cryptorchidectomy in dogs is often considered when there is concern for neoplasm or torsion of retained testes. However, this report suggests that cryptorchidectomy should be considered also to preclude the possibility of bowel obstructive emergencies. [ABSTRACT FROM AUTHOR]

Malignant mesothelioma of the tunica vaginalis testis is a rare, highly invasive urogenital malignant tumor with no specific clinical manifestations. Reported cases of this disease are limited. Therefore, an early preoperative diagnosis is difficult. The current study presents a case of malignant mesothelioma of the tunica vaginalis testis and a literature review. A 52-year-old man was admitted to Xiaoshan Affiliated Hospital of Wenzhou Medical University (Hangzhou, China) in December 2022 and underwent radical resection of the right testicle and epididymis but did not undergo radiotherapy or chemotherapy. The patient was followed up for 5 months, and no recurrence or metastasis was found. The rarity of testicular mesothelioma poses a challenge to its etiology and diagnosis, which is rarely achieved preoperatively. Malignant mesothelioma of the testicular tunica vaginalis has a poor prognosis and is not sensitive to radiotherapy or chemotherapy, requiring close postoperative follow-up. This condition is rare in clinical practice; therefore, it needs to be reported to aid clinicians' decision-making regarding diagnosis and treatment. [ABSTRACT FROM AUTHOR]

We present the case of a 32-year-old male who presented with a growing scrotal mass initially diagnosed as benign adenomatoid tumor on ultrasound 6 years prior. Repeat ultrasound showed an abnormal extra-testicular mass with nodular and cystic components and internal vascularity. A computed tomography scan of the abdomen and pelvis confirmed a right extra-testicular scrotal mass with cystic and solid enhancing components. The patient underwent radical orchiectomy and postoperative pathology diagnosed mesothelioma of the tunica vaginalis of the testis. Mesothelioma of the tunica vaginalis of the testis is an exceptionally rare disease. We discuss the risk factors, imaging features, and treatment strategies of the disease.

Primary mesotheliomas of the tunica vaginalis testis are very rare malignant tumors. They are generally associated with exposure to asbestos. They may manifest as hydrocele, testis tumor, inguinal hernia, or epididymitis. After differential diagnosis, treatment is primarily surgical. Adjuvant therapeutic methods for mesotheliomas of the tunica vaginalis testis, with their high mortality, are controversial. Here, we present a mesothelioma case derived from tunica vaginalis testis acting as long-term pyocele with no known asbestos exposure.

Abstract Background Malignant mesothelioma of the tunica vaginalis testis (MMTVT) is a rare disease with a poor prognosis. The diagnosis and management of these lesions are often difficult for pathologists, surgeons, oncologists and occupational physicians. A preoperative diagnosis of malignancy is rarely made, and there is no established effective therapy except orchidectomy. Methods A systematic literature review was conducted among the articles published in the English literature on primary MMTVT. Moreover four cases from the Apulia mesothelioma register are reported here. Results Two hundred eighty-nine cases of MMTVT have been reported from 1943 to 2018. Overall asbestos exposure has been investigated only for 58% of all cases reported in this review, while in 41.8% this data are not available. Noteworthy is the fact that in many reports there is not an anamnestic reconstruction of any asbestos exposure. A history of direct occupational, environmental or familial asbestos exposure is found in 27.6% of the cases. The four cases from the Apulia mesothelioma register are all with ascertained occupational exposure to asbestos. Conclusions The true incidence of asbestos exposure in MMTVT is underestimated because of insufficient information reported in older literature. To establish a broad consensus on the causal relationship between asbestos and MMTVT in the scientific community its necessary to analyze the same variables in the epidemiological studies. In general it should be recommended that a positive history of exposure to asbestos or to asbestos–containing materials are at risk for the development of a MMTVT and should be monitored.

Background: Tunica vaginalis (TV) flap has been used by many surgeons as a waterproof layer to cover neourethra. We present our experience in using free TV graft as an alternative to TV flap for providing waterproof cover in second-stage hypospadias repair.Materials and Methods: A retrospective review of ten patients with severe hypospadias who underwent Stage II hypospadias repair over a period of 15 months was carried out. Free TV graft was used to cover neourethra in all the patients.Results: The median age of patients was 3.5 years. Six patients had proximal hypospadias with severe chordee and four patients had peno-scrotal hypospadias. Eight patients had undergone Byars procedure and two patients had undergone Bracka's procedure during the first stage repair in the same institute. The mean operative time for Stage II repair using free TV graft was 150 min (standard deviation ± 15 min). All patients passed urine in good stream following stent/feeding tube removal. The average duration of hospital stay was 11 days. None of our patients developed urethrocutaneous fistula. Only one patient had superficial surgical site infection. All patients are well on follow-up after 6 months.Conclusion: Free TV graft could be used in place of TV flap as an intermediate waterproof cover to reduce the incidence of urethrocutaneous fistula in staged II hypospadias repair; however, studies involving a larger number of patients would be required to draw conclusions. [ABSTRACT FROM AUTHOR]

A 4-month-old cat with epileptic seizures and nasal discharge was presented, and diagnosed with intranasal meningoencephalocele based on the clinical symptoms and findings of CT and MRI. As liquorrhea was suspected, the meningoencephalocele was surgically excised and the postoperative course was favorable. For cribriform plate reconstruction, the autologous tunica vaginalis was used. Rhinorrhea of the cerebrospinal fluid and seizures disappeared after surgery. On CT and MRI at 7 months after surgery, septum formation between the cranial and nasal cavities was confirmed. Currently, no seizures have occurred even though no oral antiepileptic agent was administered. There are few reports of surgical treatment for meningoencephalitis, and there are no reports of reconstruction of the cribriform plate using tunica vaginalis, so we reported the details.

The aim of this study is to describe an entity of primary hydrocele accompanied with fibrosis, thickening and hemorrhagic infiltration of parietal layer of tunica vaginalis (PLTV). During a 4-year period (2011–2014), 94 boys (2.5–14 years old) underwent primary hydrocele repair. Hydrocele was right sided in 55 (58.5 %), left sided in 26 (28.7%) and bilateral in 12 patients (13.8%). Eighty three out of 94 patients (88.30%) had communicating hydrocele and the rest eleven patients (11.7%) had non-communicating. Our case group consists of 8 patients (8.51%) based on operative findings consistent with PLTV induration, thickening and hemorrhagic infiltration. Preoperative ultrasonography did not reveal any pathology of the intrascrotal structures besides hydrocele. There weren’t hyperechoic reflections or septa within the fluid. Evaluation of thickness of the PLTV was not feasible. Presence of lymph or exudate was excluded after fluid biochemical analysis. Tunica vaginalis histological examination confirmed thickening, hemorrhagic infiltration and inflammation, while there was absence of mesothelial cells. Immunochemistry for desmin was positive, excluding malignant mesothelioma. One patient underwent high ligation of the patent processus vaginalis and PLTV sheath fenestration, but one year later, he faced a recurrence. An elective second surgery was conducted via scrotal incision and Jaboulay operation was performed. The latter methodology was our treatment choice in other 7 out of 8 patients. During a 2-year postoperative follow-up, no other patient had any recurrence. We conclude that in primary hydrocele with macroscopic features indicative of tunica vaginalis inflammation, reversion of the tunica should be a part of operative strategy instead of sheath fenestration, in order to minimize the recurrence.

Background: Tubularized incised plate (TIP) urethroplasty is the most common technique noted to correct hypospadias. However, urethrocutaneous fistula (UCF) is still one of the most common complications of this technique. Several techniques of providing vascularized flaps to the neourethra have been recommended to decrease this complication rate. The aim of the study was to assess the outcome of primary repair of hypospadias using tunica vaginalis (TV) flap with those using preputial dartos (PD) fascia. Patients and Methods: Children diagnosed with hypospadias between the age group of 9 months to 18 years, who fulfilled the criteria were randomly divided into two groups by computerized randomization technique. Initially, TIP urethroplasty was done. Children with PD vascular cover were included in Group A and those with TV vascular cover were included in Group B. All the patients were followed up for a minimum of 6 months after surgery. Results: Two (10%) patients in Group A developed UCF and one (5%) patient developed stricture urethra in the follow-up period. None of the patients developed UCF in the Group B. One (5%) patient had stricture urethra in Group B. Two (10%) patient developed meatal stenosis in Group A. Two (10%) patient in Group B developed meatal stenosis. Conclusions: TV flap could be an alternative to PD flap as a vascular cover of neourethra in patients undergoing primary hypospadias repair by TIP urethroplasty.

Primary rhabdomyosarcoma of tunica vaginalis is very rare. We report a case of a 15‐year‐old man presenting as hydrocele. Pre‐operatively, no masses were detected by ultrasonography. Hydrocelectomy was performed. At surgery, a 0.8 cm polypoid nodule and diffusely thickened tunica were found. Pathologic examination finally revealed rhabdomyosarcoma. A PET‐CT was then performed and indicated scrotal implantation metastasis. The patient underwent radical inguinal orchiectomy and was treated with chemotherapy and radiotherapy after surgery. At 12 months of follow‐up, he remained disease‐free. [ABSTRACT FROM AUTHOR]

Background: Malignant mesothelioma of the tunica vaginalis is a rare tumour which comprises less than 1% of all mesotheliomas.Case Presentation: 69-years old patient with painful hard mass and hydrocele in the right scrotum to whom a right hydrocelectomy was performed. Any history of scrotal trauma or exposure to asbestos was not present. Excisional biopsy revealed a multinodular tumour with focal areas of necrosis and infiltrative growth. According to morphological and immunohistochemical findings, diagnosis of malignant biphasic mesothelioma of the tunica vaginalis testis was made. Two months after hydrocelectomy, right inguinal orchidectomy was performed. Post-surgical whole body CT scan revealed paraaortic and pararenal lymphadenopathy, likely to be metastatic. Adjuvant treatment with 6 cycles of cisplatin and pemetrexed was applied. After 3 cycles of chemotherapy, CT scan showed progression and the treatment was changed to gemcitabine 1 month after.Conclusions: Although malignant mesothelioma of the tunica vaginalis is a rare malignancy, it poses a diagnostic challenge which can mimic common inguinal or scrotal diseases such as hydrocele. Despite aggressive surgical procedures or adjuvant therapies, the prognosis remains poor. [ABSTRACT FROM AUTHOR]

BACKGROUND: Fibrous pseudotumor is a rare benign lesion, reactive in nature, which can appear in the form of nodules (single or multiple) or diffusely in the testicular tunics. Clinically it simulates a malignant tumor, so the treatment consists of radical orchiectomy. CLINICAL CASE: A 70-year-old man, who came to the clinic due to an increase in testicular volume of several months of evolution. Ultrasound revealed a right simple hydrocele, 170 cm3. Treatment consisted of hydrolectomy, using the right hemiscrotal technique. In the surgical act, multiple nodules adhered to the tunica vaginalis and albuginea were evidenced. Immunohistochemistry showed positivity for caldesmon and CK (AE1 / AE3), and negativity for desmin, actin, CD34, CD31, calretinin, EMA, CK7, CK5 / 6 and WT1. The final diagnosis was: multiple nodular fibrous pseudotumor. CONCLSUIONS: It is important to know the fibrous pseudotumor, since when obtaining an intraoperative biopsy it can be confused with a high-grade lesion. The possibility of IgG4 disease should be ruled out, because it is a systemic disease that can affect any location. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate and compare between gastric and tunica vaginalis grafts for urinary bladder augmentation. A vascularized gastric segment was used in 6 dogs for gastrocystoplaty, whereas a tunica vaginalis sheet was used in another 6 dogs. Both techniques were assessed clinically, radiographically, ultrasonographically and histologically. Urination frequency and behavior were nearly normal following the first technique versus oliguria and increased urination frequency in three animals following the second technique. Ultrasonographically showed no difference between both techniques. Cystogram showed a flared apex bladder in gastrocystoplasty versus an excellent contour and balloon shaped bladder following tunica vaginalis cystoplasty. Histological picture showed worsened gastric cystoplasty from 6 to 12 week postoperatively versus tunica vaginalis cyctoplasty that showed transition epithelium proliferation that became complete by week 12. In conclusion, Tunica vaginalis has proved advantageous for bladder augmentation than gastrocystoplasty, as it has minimal post-operative complications and act as a scaffold for creeping of bladder urothelium. [ABSTRACT FROM AUTHOR]

This study designed to assess the testis morphological features and biometrical parameters of the adult local rams and bucks. The samples were collected from a ten healthy adult rams and bucks that slaughtered in the AL- Najaf AL-Ashraf province abattoir. The testis position, shape, structures, dimensions and its relation with other parts of the region were recorded for each animal. The testis lies in the inguinal region between the cranial surfaces of the thighs. The long testis axis almost matches that of the trunk. The testis outer shape in both ram and buck revealed the oval shape. The means of the weight, length, circumference, diameter, volume, and density for the left testicular of the ram and buck were (150.2 ± 33.8 gm and 140.9 ± 88.4 gm), (10.7 ± 1.90 cm and 9.8 ± 2.5 cm), (15.07 ±1.22cmand9.05±0.78cm),(1.9±0.4cm and 1.9±0.18cm), (133.1 ± 15.9 ml and 125.9 ± 20.4 ml) and (1.13 ± 0.05 g/cm3 and 1.12 ± 12.3 g/cm3) respectively. While the means of the weight, length, circumference, diameter, volume, and density for the right testicular of the ram and buck were (154.1 ± 3.2 gm and 145.3 ± 14.3 gm), (10.13 ± 0.90 cm and 8.3 ± 1.9 cm), (16.09 ± 2.8 cm and 8.09 ± 1.5 cm), ( 2.2 ± 0.33 cm and 1.5 ± 1.22 cm), (121.89 ± 11.65 ml and 116.9 ± 16.37 ml) and (121.89 ± 11.65 ml and 116.9 ± 16.37 ml) respectively. Significant differences (p≤0.05) between the two species were observed in the means of weight, length circumference, diameter, volume, and density of testicles. However, no significant difference was seen in the biometric measurements of the left and right testicle of the ram. Meanwhile, testis volume and density were revealed a significant differences (P ≤0.05). The Tunica vaginalis (a serous membrane) was covered the most testis beneath a strong capsule that called the tunica albuginea. These layers were soft and grayish red in ram, but were darker in buck. The mediastinum layer of the testis revealed jellylike in both animals. In conclusion, the results of this study approved some differences and similarities in the testis morphological and biometrical measurements of the local adult rams and bucks.

Malignant mesothelioma of the testis is a rare condition. It usually affects the elderly. The common clinical manifestations include painless testicular mass. The tumor markers are normal. Ultrasonography helps in differentiating it from testicular tumors as these are situated at the periphery of the testis. Inguinal orchidectomy is diagnostic. Staging is usually done with abdominal computed tomography scan and chest X-ray. Role of adjuvant chemotherapy, radiotherapy, and lymph node dissection is controversial.

Mesothelioma is a rare malignancy in horses. This report describes a case in which marked hemoperitoneum, moderate anemia, and moderate dependent edema were the presenting clinical signs in a 2-year-old Standardbred stallion with mesothelioma of the vaginal tunic. On necropsy, approximately 40 L of dark red fluid distended the abdomen. A dark red mass infiltrated and effaced the right pampiniform plexus, and red nodular masses were present multifocally on the parietal and visceral peritoneal surfaces. Histopathologically, the masses were composed of malignant spindle cells with a sarcomatoid appearance. Using immunohistochemistry, tumor cells were cytokeratin and vimentin positive and factor VIII–related antigen negative: compatible with a diagnosis of mesothelioma. This is the first report of mesothelioma arising from the vaginal tunic of a horse with subsequent spread to the peritoneum. This case adds additional information regarding the clinical presentation and behavior of mesothelioma originating from the vaginal tunic in horses. • Mesothelioma is a neoplasm rarely reported in horses. • Immunohistochemistry is often necessary to definitively diagnose mesothelioma. • Mesothelioma should be a differential diagnosis for hemoperitoneum in the horse. • Prognosis for disseminated mesothelioma in the horse is grave. [ABSTRACT FROM AUTHOR]