Leiomyoma of scrotum: A rare case report

Introduction and importance: Scrotal Leiomyoma is a benign and rare mesenchymal tumor that grows slowly. It was reported for the first time in 1858 by Forster. The Patients with Scrotal Leiomyoma is an asymptomatic painless mass. Case presentation: The patient was a 45-year-old man, who presented with a painless scrotal mass to our hospital. On physical examination, he had a single, firm, and mobile mass about 2-3 cm in diameter within the right scrotum without tenderness. The left side was normal. Pre-operative scrotal sonography, a 2.5 cm hypoechoic extra testicular mass with sharp borders was reported. Intraoperatively The mass was excised totally and the testis was preserved. On microscopic examination revealed interlacing bundles of spindle-shaped cells with no mitotic figures or nuclear pleomorphism. On immunohistochemical analysis, the spindle cells were positive for SMA and negative for S100, and leiomyoma was confirmed. Clinical discussion: For diagnosing leiomyoma, scrotal ultrasound is a first-line and noninvasive method that is confirmed by histologic examination. In histology, smooth muscle bundles are seen. Immunohistochemistry studies can confirm the diagnosis by identifying specific markers like vimentin, desmin, and smooth muscle actin. It is important to differentiate leiomyoma from a malignant type known as leiomyosarcoma. Conclusion: We report a rare case presentation of a 45-year-old man with scrotal leiomyoma that is confirmed by histology. It is important to differentiate leiomyoma from malignant course.