Leiomyoma of scrotum

LEIOMYOMA KEVIN THOMAS

OF SCROTUM

M. TOMERA, A. GAFFEY,

IRWIN

S. GOLDSTEIN,

HORST

ZINCKE,

M.D. M.D. M.D.

M.D.

From the Departments of Urology Mayo Clinic and Mayo Foundation,

ABSTRACT - Leiomyomas case of bilateral leiomyomas

arising from the tunica dartos scroti are rare tumors. of the scrotum.

Leiomyomas of the scrotum are rare. In 1937, the world literature, stout, l after reviewing found only 5 cases. Herbut’ noted only 1 case in more than twenty-seven years of active practice in urology. Siegal and Gaffey3 from the Mayo after a reClinic reported only 11 leiomyomas view of more than 11,000 benign and malignant lesions of the scrotum and its contents. We are documenting the first case of bilateral leiomyomas of the tunica dartos scroti. Case Report A seventy-eight-year-old white man underwent elective right inguinal herniorrhaphy. He had noted bilateral, asymptomatic scrotal masses for several years. The size of the masses had not changed. Physical examination revealed a small, reducible, right, inguinal hernia. Nontender, hard, irregular, movable masses, approximately 5 by 5 cm., were present on both sides of the scrotal sac. The tumors did not transmit light and appeared to be separate from the testes. Exploration through bilateral high inguinal incisions with attention to isolation of the cord revealed that the tumors were not fixed to the overlying skin. Resection was accomplished easily, and a McV’ay repair of the small, right direct hernia was performed. Grossly, the right scrotal mass was 4.5 cm. in diameter, and the left scrotal mass was 4.3 cm.

388

and Surgical Pathology, Rochester, Minnesota

We report

the&-St

(Fig. 1). The testes and epididymides were not involved. Microscopically, the lesions were circumscribed but not encapsulated. The smooth muscle fibers were arranged in classic interlacing and whorling bundles (Fig. 2). The size of the individual muscle bundles varied. The nuclei were uniform, long, and blunt-ended. No mitotic figures were seen. Comment Modern textbooks classify leiomyomas as multiple and solitary. ’ Further division is made as to the tissue of origin and anatomic location.

FIGURE

whorled

UROLOGY

1. Cut section uppearance.

/ OCTOBER

I%1

of specimen,

1 VOLCME

note

XVIII,

typical

NUSIBER

4

Holstein. Orlandini. and Baumgarten” ohserved l~nndles of smooth muscles and single muscle cells in the corium. The individual cells resembled myofibroblast cells having characteristics of smooth muscle and fibroblasts. These cells wert’ not inflrlenced l,!. the sympathetic nervous s)‘stern as the muscle bundles were influenced. Leiomyomas of the tunica dartos arise from tht individual myofihrol~lasts in the corium, and these cells pish into the o\~erlying siihcutis. is a rare, benigri lesion Dartoid leioni~~oina males who Iiiost frcrisuall~~ affecting white cpentl> are in the fourth to the sixth decades. hlost patients have noted the mass for some time and present with complaints relating to 01 conconiitant inguinal hernia, or liydro~t~le. lmth.”

Sllrgical

resection

is simple

and

curati\~e.

:i s !)