Acta Med. 2018, 61: 41-46

Tunica Vaginalis Thickening, Hemorrhagic Infiltration and Inflammatory Changes in 8 Children with Primary Hydrocele; Reactive Mesothelial Hyperplasia? A Prospective Clinical Study

Ioannis Patouliasa, Evangelia Rachmania, Maria Kalogiroub, Kyriakos Chatzopoulosc, Dimitrios Patouliasd

a1st Department of Pediatric Surgery, Aristotle University of Thessaloniki, General Hospital “G. Gennimatas”, Thessaloniki, Greece
b4th Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, Greece
cDepartment of Pathology, General Hospital “G. Gennimatas”, Thessaloniki, Greece
dDepartment of Internal Medicine, General Hospital of Veria, Veria, Greece

Received June 28, 2017
Accepted June 5, 2018


1. Dave J. Cause and management of hydrocele: a review article. Indian J of Applied Research 2015; 5(10): 117–8.
2. DeVries C. The role of urologist in the treatment and elimination of lymphatic filariasis worldwide. BJU Int 2002; 89(1): 37–43. <>
3. Tahir MS. Hydrocele. Indep Rev 2014; 16(4–6): 145–50.
4. Tarantino L, Giorgio A, de Stefano G, Farella N. Εcho color Doppler findings in post pubertal mumps epididymo orchitis. J Ultrasound Med 2001; 20: 1189–95. <>
5. Zaslau S, Perlmutter AE, Farivar-Mohseni H, Chang WW, Kandzari SJ. Rhabdomyosarcoma of tunica vaginalis masquerading as hydrocele. Urol 2005; 65: 1001. <>
6. Cimador M, Castagnetti M, De Grazia E. Management of hydrocele in adolescent patients. Nat Rev Urol 2010; 7(7): 379–85. <>
7. Rubenstein A, Dogra VS, Seftel AD, Resnick MI. Benign intrascrotal lesions. J Urol 2004; 171: 1765–72. <>
8. Puttermans T, Ingabire MI, Jorion JL, Draguet AP. Fibrous pseudotumor of the tunica vaginalis: contrast enhanced sonography with pathologic correlation. JBR-BTR 2014; 97: 259–61.
9. Garriga V, Serrano A, Marin A, et al. US of tunica vaginalis testis: Anatomic relationships and pathologic conditions. Radiographics 2009; 29: 2017–32. <>
10. Mostophi FK, Price EB. Tumors of the male genital system. In: Atlas of tumor pathology, 2nd series, Fascicle 8, Wasington DC: Armed Forces Institute Pathology, 1973: 151.
11. Parker PM, Pugliese JM, Allen RC. Benign fibrous pseudotumor of tunica vaginalis testis. Urol 2006; 68: 427e17–e19.
12. Navai N, Yap RL, Gupta R, Fraser TG, Gonzalez CM. Inflammatory pseudotumor of the testis: a novel presentation of acute retroviral syndrome. Int J Urol 2005; 12: 424–6. <>
13. White WM, Hilsenbeck J, Waters WB. Fibromatous periorchitis of testis. Urology 2006; 67(3): 623.e15–6.
14. Holcomb GW, Murhy JP, Ostlie DJ. Ashcraft’s Pediatric Surgery. 6th edition. New York: Elsevier Saunders, 2014, Chapter 50, pp 679–88.
15. Andrews EW. The “Bottle Operation” method for the radical cure of hydrocele. Ann Surg 1907; 46: 915–8. <> <PubMed>
16. Belman AB. Abdominoscrotal hydrocele in infancy: a review and presentation of the scrotal approach for correction. J Urol 2001; 165(1): 225–7. <>
17. Koutsoumis G, Patoulias I, Kaselas C. Primary new-onset hydroceles presenting in late childhood and pre-adolescent patients resemble the adult type hydrocele pathology. J Pediatr Surg 2014; 49: 1656–8. <>
18. Wilson JM, Aaronson DS, Schrader R, Baskin LS. Hydrocele in the pediatric patient: inguinal or scrotal approach? J Urol 2008; 180: 1724–8. <>
19. Ozdilek S. The pathogenesis of idiopathic hydrocele and a simple operative technique. J Urol 1957; 77: 282–4. <>
20. Rinker J, Allen L. A lymphatic defect in hydrocele. Am Surg 1951; 17: 681–6.
21. Ku JH, Kim M, Lee NK, Park YH. The excisional, plication and internal drainage techniques: a comparison of the results for idiopathic hydrocele. BJU Int 2001; 87: 82–4. <>
22. Algaba F, Mikuz G, Boccon-Gibod L, et al. Psudoneoplastic lesions of the testis and paratesticular structures. Virchows Archiv 2001; 451(6): 987–97. <> <PubMed>
23. Perez-Ordonez B, Srigley JR. Mesothelial lesions of the paratesticular region. Semin Diagn Pathol 2000; 17: 294–306.
24. Colecchia M, Mikuz G, Algaba F. Rare tumors of the testis and mesothelial proliferation in the tunica vaginalis. Tumori 2012; 98: 270–3. <>
25. Erdogan S, Acikalin A, Zeren H, et al. Well-Differentiated Papillary Mesothelioma of the Tunica Vaginalis: A Case Study and Review of the Literature. Korean J Pathol 2014; 48(3): 225–8. <> <PubMed>
26. Bolen JW, Hammar SP, McNutt MA. Reactive and neoplastic serosal tissue. A light-microscopic, ultrastructural, and immunocytochemical study. Am J Surg Pathol 1986; 10: 34–47. <>
27. Tyagi G, Munn CS, Kiser LC, Wetzner SM, Tarabulcy E. Malignant mesothelioma of tunica vaginalis testis. Urol 1989; 34: 102–4. <>
28. Chen JL, Hsu YH. Malignant mesothelioma of the tunica vaginalis testis: a case report and literature review. Kaohsiung J Med Sci 2009; 25: 77–81. <>
29. Goel A, Agrawal A, Gupta R, Hari S, Dey AB. Malignant mesothelioma of the tunica vaginalis of the testis without exposure to asbestos. Cases J 2008; 1: 310. <> <PubMed>
30. Friedman MT, Gentile P, Tarectecan A, Fuchs A. Malignant mesothelioma: immunohistochemistry and DNA ploidy analysis as methods to differentiate mesothelioma from benign reactive mesothelial cell proliferation and adenocarcinoma in pleural and peritoneal effusions. Arch Pathol Lab Med 1996; 120(10): 959–66.
31. De Lima GR, De Oliveira VP, Reis PH, et al. A rare case of malignant hydrocele in a young patient. J Pediatr Urol 2009; 5(3): 243–5. <>
32. Tolhurst SR, Lotan T, Rapp DE, et al. Well-differentiated papillary mesothelioma occurring in the tunica vaginalis of the testis with contralateral atypical mesothelial hyperplasia. Urol Oncol 2006; 24: 36–9. <>
front cover

ISSN 1211-4286 (Print) ISSN 1805-9694 (Online)

Open access journal