Intratesticular Leiomyoma: A Case Report

Abstract

The majority of intratesticular masses are malignant. Although uncommon, benign lesions can be found as an intratesticular mass. An extremely rare lesion in the testicle is a leiomyoma, which has only been reported a handful of times in the literature. We report here a case of intratesticular leiomyoma, the associated imaging, and pathologic findings.

Intratesticular Leiomyoma: Lessons Learned From a Case Report and Another Contribution to Enlarge a Small World Series

“…However, because it has the same radiological semiology as malignant tumors, which constitute the majority of testicular tumors, it cannot be diagnosed using ultrasonography or magnetic resonance imaging. As a result, the definitive diagnosis is established once the specimen has been examined histopathologically [10], and the treatment of choice is generally a radical orchiectomy [4][5][6]9,10].…”

“…Leiomyoma of the testis is an uncommon condition [ 6 ]. To our best knowledge, only about 18 cases have been reported to date in the English literature since the first case was described in 1972 [ 4 ]. Leiomyomas are soft-tissue benign tumors that develop from smooth muscle [ 6 ].…”

“…Indeed, the existence of a testicular mass should not be considered a sign of malignancy, and frozen section evaluation should be part of the treatment arsenal, which may lead to enhanced testicular preservation in particular cases [ 11 ]. The fact that leiomyomas are difficult to distinguish from malignancy on imaging and that the majority of testicular lesions are malignant justifies this approach [ 4 , 6 ]. Had the current case undergone intraoperative frozen section examination (FSE) of the intratesticular mass, testicular preservation approach would have been attempted as long as the specificity and sensitivity of intraoperative frozen section evaluation for the differential diagnosis of benign and malignant testicular lesions were excellent [ 12 ].…”

“…Nevertheless, benign lesions do also exist, and may include teratoma, benign sex cord-stromal tumor (Leydig and Sertoli cell tumors) and lipoma. They may be encountered in up to 80% of testicular lesions smaller than 3 cm with a long duration of symptoms (>6 months) [ 3 ], raising both diagnostic and therapeutic challenges [ 4 , 5 ]. Herein, we describe a rare case of benign testicular tumor, which occurred in a 44-year-old man and proved to be an intratesticular leiomyoma on histopathology.…”