Abstract
Smooth muscle hamartoma (SMH) is a rare benign lesion characterized by an overgrowth of smooth muscle fibers, typically originating from the arrector pili muscles in the dermis. We report the case of a 39-year-old male sailor with a progressively enlarging scrotal for several years, with rapid enlargement within the past year. The mass was intermittently painful, especially during physical exertion. The patient underwent successful surgical excision with bilateral orchidopexy. Histopathological and immunohistochemical analysis confirmed the diagnosis of ASMH. Postoperative recovery was uneventful. This case highlights the importance of considering ASMH in the differential diagnosis of scrotal masses. Conservative testis-sparing surgery can result in excellent outcomes.