Soft tissue sarcomas of the genitourinary tract are rare. Paratesticular sarcomas are extremely rare with majority of scrotal masses localizing to the testis and being neoplastic in nature. Paratesticular leiomyosarcomas (LMSs) are located in the spermatic cord, epididymis, or scrotum. However, their location in the scrotal skin or subcutaneous tissue is extremely rare. Only 10 cases have been reported from India previously. Ours is the 11th case. A 50-year-old male presented with a recurrent scrotal mass which was painless and gradually increasing in size. Histopathology and immunohistochemistry confirmed it to be paratesticular LMS. A rare case report with the review of literature is presented.
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