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.