Departments of Dermatology, and.
Laboratory Medicine & Pathology, Mayo Clinic, Rochester, MN.
Am J Dermatopathol. 2024 Oct 1;46(10):e91-e95. doi: 10.1097/DAD.0000000000002802. Epub 2024 Jul 12.
Paratesticular mesothelioma (malignant mesothelioma arising from the tunica vaginalis of the testis) represents a small proportion of mesothelial neoplasms, and cutaneous involvement by paratesticular mesothelioma is very rare. Cutaneous involvement can manifest as scrotal subcutaneous nodules from regional spread, distant metastasis, or direct extension through surgical scars. Mesothelioma has 3 histopathologic classifications that include epithelioid, biphasic, and sarcomatoid, which is rarely seen in paratesticular mesothelioma. Given the rarity of this condition, cutaneous mesothelioma may be misdiagnosed as histologic mimics, such as metastatic adenocarcinoma or adnexal neoplasms; thus, appropriate immunohistochemical workup and clinical correlation are required to make an accurate diagnosis. In this case, a 75-year-old man with a history of paratesticular mesothelioma, status postorchiectomy, presented with right-sided scrotal swelling, erythema, and subcutaneous nodules. These nodules were identified as local recurrence with cutaneous involvement by paratesticular mesothelioma on histopathologic examination. This case highlights the clinical and histopathologic features of this diagnosis and underscores the importance of dermatopathologists being aware of this condition to ensure accurate diagnosis.
睾丸旁间皮瘤（源自睾丸鞘膜的恶性间皮瘤）占间皮瘤的一小部分，睾丸旁间皮瘤累及皮肤非常罕见。皮肤受累可表现为来自局部播散、远处转移或通过手术瘢痕直接扩展的阴囊皮下结节。间皮瘤有 3 种组织病理学分类，包括上皮样、双相和肉瘤样，这在睾丸旁间皮瘤中很少见。鉴于这种情况很少见，皮肤间皮瘤可能被误诊为组织学模拟物，如转移性腺癌或附属肿瘤；因此，需要进行适当的免疫组织化学检查和临床相关性检查以做出准确的诊断。在本例中，一名 75 岁男性，有睾丸旁间皮瘤病史，行睾丸切除术，出现右侧阴囊肿胀、红斑和皮下结节。这些结节在组织病理学检查中被确定为局部复发伴睾丸旁间皮瘤皮肤受累。本例强调了这种诊断的临床和组织病理学特征，并强调了皮肤科病理学家了解这种情况以确保准确诊断的重要性。
