Recurrent Leiomyosarcoma of The Scrotum

Journal of Urology, 1965

The American Journal of Surgical Pathology, 2014

Smooth muscle tumors of the scrotum are very uncommon, and those with degenerative-appearing atypia, variably designated as "atypical," "symplastic," or "bizarre" leiomyomas, are extremely rare with only 11 cases in the literature. Given their rarity, the diagnostic criteria and prognosis of symplastic leiomyomas are not well established. We describe 9 cases of scrotal symplastic leiomyomas and compare their histopathologic characteristics to 10 usual leiomyomas and 5 leiomyosarcomas of the scrotum. The preoperative diagnosis was scrotal tumor or cyst in all cases. The mean age was 46 years (range, 32 to 60 y) for usual, 59 (range, 48 to 79) for symplastic leiomyomas, and 57 (range, 49 to 65) for leiomyosarcoma. Submitting diagnoses for symplastic leiomyomas were: atypical spindle cell lesion (n = 3); probably leiomyosarcoma (n = 1); leiomyosarcoma (n = 1); and none given (n = 4). Symplastic leiomyomas were diagnosed when there was moderate-severe cytologic atypia, yet was degenerative-appearing with multinucleation or smudged chromatin in the setting of low nuclear/cytoplasmic ratio, low cellularity, and no mitotic activity. The mean size was 1.0 cm for usual leiomyomas, 1.0 cm for symplastic leiomyomas, and 2.0 cm for leiomyosarcomas. Leiomyosarcomas had high nuclear/cytoplasmic ratio, high cellularity, nuclear pleomorphism, and hyperchromasia. Five of 10 usual and 3/9 symplastic leiomyomas showed at least 1 ill-defined border simulating infiltrative growth. Three leiomyosarcomas were grade 1, and 2/5 were grade 2. Resection margins were positive in 5/10 usual and 3/9 symplastic leiomyomas and in 1/5 leiomyosarcoma. Ki67 labeling in usual leiomyomas was on average 2.4% (range, 1% to 5%) and in symplastic leiomyomas was 1.8% (range, 1% to 5%). Mitoses were absent in all cases of usual and symplastic leiomyomas. Mitotic figures averaged 4.7 (range, 1 to 7) and 13.5 (range, 7 to 20) per 10 HPF for the grade 1 and 2 leiomyosarcomas, respectively. None of the symplastic leiomyomas recurred after a median follow-up of 27 months. The 2 patients with grade 2 leiomyosarcoma had no evidence of metastases at 6 and 7 months follow-up, respectively. Scrotal symplastic leiomyomas may have an ill-defined infiltrative border, which along with their atypia mimic malignancy. Ki67 is low in symplastic leiomyomas, which along with their favorable follow-up and experience in other organs justifies a benign diagnosis. High cellularity and high mitotic activity are the most reliable features for the diagnosis of scrotal leiomyosarcoma.

Urology Case Reports, 2020

Leiomyoma is a benign tumor originating from smooth muscle cell, Mostly from uterus. However, in men is a very rare entity. Scrotal leiomyoma is a very rare tumor. Here we presented a case of scrotal leiomyoma in a 71year-old man. He presented with a slowly growing, painless mass and heaviness in the left testis for 10 years. Due to huge size, testicular attachment and preoperational diagnosis of atypical leiomyoma/leiomyosarcoma, orchiectomy was performed. Pathology report diagnosed leiomyoma. We suggest frozen section diagnosis as a useful tool, to prevent unnecessary procedure.

Indian Dermatology Online Journal, 2015

Paratesticular leiomyosarcoma originates from testicular tunica (48%), spermatic cord (48%), epididymis (2%) and dartos muscle, as well as subcutaneous tissue of the scrotum (2%). Leiomyosarcomas of the scrotum, not involving the testis, epididymis or spermatic cord, are rare, and belong to the group of subcutaneous superficial leiomyosarcomas. To the knowledge of the authors, less than 10 cases of leiomyosarcoma of the scrotum have so far been reported from India. The tumor usually presents as a painless, slow-growing scrotal mass in middle-aged or elderly men. The current approach is wide local excision, often with adjuvant therapy. The prognosis is usually good following complete excision, though a local recurrence rate of 40% has been reported. Long term follow-up is, therefore, necessary to monitor for recurrence. Herein we present the case of 35-year-old male who presented with an exophytic scrotal mass. Histopathological and immunohistochemical findings of the mass were consistent with leiomyosarcoma.

World Journal of Surgical Oncology, 2011

Giant leiomyosarcoma of scrotum is a rare tumour. A case of scrotum leiomyosarcoma is presented in a 67 year old patient with scrotal filariasis which was managed successfully with total scrotectomy with bilateral orchidectomy, degloved penis reconstructed with rotation advancement supra pubic fasciocutaneous flap. We made a literature search proving the rarity of this lesion type. Only 36 cases have been described and the first case in a filarial scrotum

Journal of Korean Medical Science, 2003

Scrotal leiomyomas with atypical bizarre nuclei are rare, which might be misdiagnosed as malignant tumor. We describe a case of scrotal bizarre leiomyoma in a 65-yr-old man. The tumor was a 1 cm-sized, well circumscribed, oval mass arising from the tunica dartos muscle. Histologically, it was formed by whorling bundles of fusiform cells with occasional atypical, pleomorphic nuclei and pseudo-inclusions. Mitosis was not found. Although morphologically atypical, scrotal bizarre leiomyomas take on a biologic behavior not different from that of conventional leiomyoma, they should be distinguished from leiomyosarcoma to avoid unnecessary treatment.

Nigerian Hospital Practice, 2020

Background: Leiomyoma is a benign tumour of smooth muscles that can arise almost anywhere in the body; however, scrotal Leiomyomais a rare entity. It may originate from dartos muscle, epididymis or spermatic cord. The neoplasm has an insidious course, and clinically it may mimic many intrascrotal tumours, including testicular cancers, resulting in diagnostic challenges.Case report: A 20-year-old student evaluated for a painless right testicular swelling of 1year duration, suspicious of right testicular cancer. He had right radical orchidectomy done, but the histology result of the specimen came out to be paratesticular leiomyoma compressing and causing total atrophy of the right testis, the specimen measured 10x7x6cm and weighed 600g. Post-operative condition and follow up were satisfactory.Conclusion: Scrotal leiomyoma is rare and when it presents as huge mass can cause challenges in diagnosis and treatment, particularly in developing countries. Close follow-up and molecular testin...

Leiomyoma is a benign tumor of smooth muscles. Leiomyoma originating from the scrotum is a rare entity. We report a case of 53-year-old African male who presented with a 3 cm lump in the right side of scrotum. Clinically, it was provisionally diagnosed as sebaceous cyst and was excised. The histopathology showed a leiomyoma. There was no cytological atypia or mitosis. The patient also had squamous papilloma over left gluteal region.

Case report, 2020

Leiomyosarcoma (LMS) is a malignant mesenchymal neoplasm arising from the smooth muscle. Paratesticular LMSs are commonly located in the epididymis or spermatic cord. Pure scrotal cutaneous paratesticular LMS arising from the dartos muscle is very rare. Less than 40 cases have been reported in the literature to date. We report a case of pure scrotal cutaneous LMS in a 45‑year‑old patient.

International Surgery Journal

Sarcomas of the genitourinary tract are extremely uncommon and accounts for only 1-2% of genito urinary malignancies. Sarcomas of the para testicular region, comprising tissues such as the epididymis, spermatic cord, inguinal canal and testicular tunica are also extremely rare. epidydimal leiomyosarcoma accounted only for 4 percentage of all para testicular tumours and only 16 cases are reported so far in literature and they account 4% of all Para testicular sarcomas. We are presenting a 61-year-old patient presented with a hard welling of 1 year duration, with no other associated symptoms. On ultrasound evaluation, it was reported as extra testicular lesion, possibly from epididymal tail. We performed a high inguinal orchidectomy. Histopathological examination revealed a para testicular leiomyosarcoma arising from epididymis. This case has discussed because of the rarity of the disease and possible cure if diagnosed early and treated aggressively.