Malignant Mesothelioma of the Epididymis: A Case Report of a Rare Paratesticular Neoplasm and Literature Review

Background: Malignant mesothelioma of the epididymis is an extremely rare neoplasm with a poor prognosis and high potential of recurrence. Case Presentation: We report a case of a 28-year-old male with a left painless epididymal nodule. Scrotal ultrasound revealed a nodular mass with mixed echogenicity and Doppler showed increased vascularity. Radical orchidectomy was performed. Histopathological examination concluded to a malignant mesothelioma involving the epididymis. Metastatic workup was negative. The patient has undergone a regular follow-up and has been disease-free within 6 months. Conclusion: Malignant mesothelium of the epididymis is a diagnosis challenge. Surgery remains the main treatment. A multidisciplinary management should be offered in those cases.