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HISTOPATHOLOGY SECTION - CASE REPORT Table of Contents   
Year : 2008  |  Volume : 51  |  Issue : 1  |  Page : 72-73
Leiomyoma of scrotum


Department of Pathology, JNMCH, Aligarh Muslim University, Aligarh, Uttar Pradesh, India

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   Abstract 

Leiomyoma is a benign tumor of smooth muscles. Leiomyoma originating from the scrotum is a rare entity. We report here a case of 50-year-old male who presented with a 4-cm lump in the left side of scrotum. Clinically, it was provisionally diagnosed as sebaceous cyst and was excised. The histopathology showed findings consistent with leiomyoma. There was no cytological atypia or mitosis. The final diagnosis of solitary leiomyoma of scrotum was given. The patient was followed up regularly and is doing fine for last 4 months.

Keywords: Leiomyoma, scrotum, genital leiomyoma

How to cite this article:
Sherwani R K, Rahman K, Akhtar K, Zaheer S, Hassan M J, Haider A. Leiomyoma of scrotum. Indian J Pathol Microbiol 2008;51:72-3

How to cite this URL:
Sherwani R K, Rahman K, Akhtar K, Zaheer S, Hassan M J, Haider A. Leiomyoma of scrotum. Indian J Pathol Microbiol [serial online] 2008 [cited 2019 Dec 12];51:72-3. Available from: http://www.ijpmonline.org/text.asp?2008/51/1/72/40405



   Introduction Top


Leiomyoma is a benign tumor of smooth muscles. Superficial leiomyoma of skin and subcutaneous tissue may be of three types; (a) tumor of arrector pili muscle (piloleiomyoma), (b) tumors of smooth muscles of blood vessels (angioleiomyoma), and (c) genital leiomyoma (from the smooth muscles of nipple, vulva, and scrotum). [1]

Smooth muscle tumors of scrotum were first described by Forsters in 1858 and are reported to be extremely rare. [2] Siegal and Gaffey [3] demonstrated the rarity of this tumor finding only 11 cases in a review of 11 000 cases of scrotal tumor. Scrotal leiomyoma are the uncommon tumors that arise from the subcutaneous tissue or dartos muscle. [3]

We report here a case of scrotal leiomyoma which was unique to us.


   Case History Top


A 50-year-old male presented with the complaints of a painless lump in the left side of the scrotum for 10 months. Physical examination revealed a soft to firm, nontender, mobile, and oval lump of 4 x 3 x 3 cm 3 on the anterior side of left scrotum. It could be felt separate to testes or the adnexal structures. The overlying skin was normal without any ulceration. Both the testes were normal without any palpable inguinal lymph node.

The lump was diagnosed as a sebaceous cyst. It was excised and sent to pathology department for histopathological evaluation.

Grossly it was a single, skin covered, and firm tissue mass of 4 x 3 x 2.5 cm 3 . Cut surface showed solid, homogenous character with whorling [Figure - 1].

Microscopically a well-circumscribed tumor was seen composed of interlacing bundles of smooth muscles with varying amount of admixed collagen, well delineated from the skin [Figure - 2]. Individual muscle cells were uniform in size and shape with oval nuclei and bipolar cytoplasm. There was no evidence of cytological atypia or mitotic figures [Figure - 3].


   Discussion Top


Leiomyoma is a benign tumor of smooth muscles that can arise almost anywhere in the body. Leiomyoma of skin and subcutaneous tissue can be divided into three subtypes. They include cutaneous (Pilar) leiomyoma, genital leiomyoma, or more deeply situated angioleiomyoma (vascular leiomyoma).

Genital leiomyoma include those involving scrotum, vulva, or nipple. Newman and Fletcher analyzed a series of 32 cases of genital leiomyoma. They found nipple leiomyoma comparable to the cutaneous leiomyoma in terms of size and histology, but vulval and scrotal leiomyoma were found to be clinicopathologically quite different. [4] These are the rare tumors and have received little attention in the literatures.

Scrotal leiomyoma arise from the dartos muscle and is a rare tumor with <50 cases reported. [5] It occurs most often in white men between fourth and sixth decades of life. Patients usually present with painless solitary small cutaneous lesion measuring 1-14 cm with the average of 6.4 cm. [4] The painless nature of scrotal leiomyoma corresponds well with the slow growing nature of the tumor pushing the nerve trunk outward rather compressing it. [5] Because of the asymptomatic, painless, and slow growing nature of the tumor, patients usually present late with an average of 7.6 years between the patient's recognition of the tumor and its surgical removal. [3] In our case, the patient presented within 10 months of lump recognition. It may be because of relative rapid growth of the lump that reached to a size of 4 cm within this duration or because of the inquisitive nature of the patient who sought medical attention at an early stage.

In a review of Newman and Fletcher, [4] the presence of any mitotic activity was advocated as a criterion of potential malignancy. Thus, it is important for the pathologist to look for them carefully.

Simple excision is indicated and is curative for leiomyoma. [6] Radiation should be avoided as it may induce a malignant transformation. Follow-up is required and if recurrence is there a thorough investigation should be carried out to rule out any possibility of malignancy.

 
   References Top

1.Livne PM, Nobel M, Savir A, Avidor I, Servadio C. Leiomyoma of the scrotum. Arch Derm 1983;119:358-9.  Back to cited text no. 1  [PUBMED]  
2.Das AK, Bolick D, Little NA, Walther PJ. Pedunculated scrotal mass: Leiomyoma of scrotum. Urol 1992;39:376-9.  Back to cited text no. 2  [PUBMED]  [FULLTEXT]
3.Siegal GP, Gaffey TA. Solitary leiomyoma arising from tunica dartos scroti. J Urol 1976;16:69-71.  Back to cited text no. 3    
4.Newman PL. Fletcher CD. Smooth muscle tumors of external genitalia. Clinicopathological analysis of a series. Histopathology 1991;18:523-9.  Back to cited text no. 4    
5.Kim NR, Sung CD, Han J. Bizarre leiomyoma of scrotum. J Korean Med Sci 2003;18:452-4.  Back to cited text no. 5    
6.Ileorata AT, Belkirov H, Newman HR. Leiomyoma of scrotum. Urology 1977;10:48-9.  Back to cited text no. 6    

Top
Correspondence Address:
R K Sherwani
Gul-e-Rana, Nagla Road, Dodhpur, Aligarh - 202 002, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0377-4929.40405

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    Figures

  [Figure - 1], [Figure - 2], [Figure - 3]

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    Abstract
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