Abstract
INTRODUCTION: Leiomyomas are rare benign mesenchymal tumors originating from smooth muscle cells. Scrotal leiomyomas, in particular, are exceptionally rare, with a prevalence rate of 1 in 1000 among all scrotal tumors. METHODS: This case Report has been Reported in line with SCARE Criteria. PRESENTATION OF THE CASE: A 55-year-old Caucasian male presented with a five-year history of painless scrotal swelling, gradually increasing in size. Clinical examination revealed a non-tender oval lump on the right hemiscrotum. The right testis and cord structures were distinguishable from the mass. While the initial clinical assessment was suggestive of a sebaceous cyst, further evaluation was performed. A wide local excision of the lump was performed and sent for histopathological evaluation. Microscopy indicated a well-circumscribed, non-atypical leiomyoma with no necrosis or increased mitosis, providing us with a definitive diagnosis. DISCUSSION: Scrotal leiomyomas are a rare subset of genital leiomyomas, mostly found in middle-aged Caucasian men. Pathological examination is the mainstay to distinguish these tumors into typical and atypical leiomyomas, impacting treatment decisions. Simple surgical excision is curative, and Irradiation is contraindicated. CONCLUSION: Scrotal leiomyomas should be considered in the differential diagnosis of scrotal masses. This case emphasizes the necessity of wide local excision, with adequate clearance, and regular follow-up to rule out recurrence, particularly given the potential for atypia and progression to leiomyosarcoma. The prognosis overall is good as recurrence rates are low.