A rare case of leiomyosarcoma arising from testis in an adult male: a case report

Introduction and Importance: Leiomyosarcoma (LMS) is a neoplasm characterized by the uncontrolled proliferation of smooth muscle cells. Even though it can develop in the uterus, gastrointestinal tract, or blood vessels, it is an exceptional presentation at a urologist's clinic, specifically as a primary tumor. Due to its rarity, further research is needed to understand and manage this malignancy in a timely manner. Case Presentation: The present report presents the case of an elderly male who visited the urology department due to a mass in his right hemiscrotum. Clinical and laboratory investigations revealed insignificant results. The provisional diagnosis of LMS was made through an inguinoscrotal ultrasound, and a radical orchiectomy was performed. The patient remained stable and was discharged on the third postoperative day. On his follow-up visit, the histopathological examination report showed high-grade (FNCLCC grade 3) intratesticular LMS with pathological stage T1N0M0. Clinical Discussion: Although the exact etiology of intratesticular LMS is unknown, it should be considered in differential diagnosis in seronegative testicular masses. Conclusion: Due to its unique characteristics as a primary tumor in the testis, as well as its relatively low invasiveness and reduced tendency for metastasis, close observation combined with radical orchiectomy can be considered a viable therapeutic option for LMS.