Karimi Mohadeseh, Rad Hanieh
Department of Pathology, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
Department of Pathology, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
Int J Surg Case Rep. 2024 Dec;125:110490. doi: 10.1016/j.ijscr.2024.110490. Epub 2024 Oct 19.
Scrotal Leiomyoma is a benign and rare mesenchymal tumor that grows slowly. It was reported for the first time in 1858 by Forster. The Patients with Scrotal Leiomyoma is an asymptomatic painless mass.
The patient was a 45-year-old man, who presented with a painless scrotal mass to our hospital. On physical examination, he had a single, firm, and mobile mass about 2-3 cm in diameter within the right scrotum without tenderness. The left side was normal. Pre-operative scrotal sonography, a 2.5 cm hypoechoic extra testicular mass with sharp borders was reported. Intraoperatively The mass was excised totally and the testis was preserved. On microscopic examination revealed interlacing bundles of spindle-shaped cells with no mitotic figures or nuclear pleomorphism. On immunohistochemical analysis, the spindle cells were positive for SMA and negative for S100, and leiomyoma was confirmed.
For diagnosing leiomyoma, scrotal ultrasound is a first-line and noninvasive method that is confirmed by histologic examination. In histology, smooth muscle bundles are seen. Immunohistochemistry studies can confirm the diagnosis by identifying specific markers like vimentin, desmin, and smooth muscle actin. It is important to differentiate leiomyoma from a malignant type known as leiomyosarcoma.
We report a rare case presentation of a 45-year-old man with scrotal leiomyoma that is confirmed by histology. It is important to differentiate leiomyoma from malignant course.
阴囊平滑肌瘤是一种生长缓慢的良性罕见间叶组织肿瘤。1858年由福斯特首次报道。阴囊平滑肌瘤患者表现为无症状的无痛性肿块。
患者为一名45岁男性，因阴囊无痛性肿块来我院就诊。体格检查发现，其右侧阴囊内有一个直径约2 - 3厘米的单一、质地坚硬且可活动的肿块，无压痛。左侧正常。术前阴囊超声检查报告显示一个边界清晰的2.5厘米低回声睾丸外肿块。术中将肿块完整切除并保留了睾丸。显微镜检查显示为交错排列的梭形细胞束，无有丝分裂象或核异型性。免疫组化分析显示，梭形细胞平滑肌肌动蛋白（SMA）阳性，S100阴性，确诊为平滑肌瘤。
对于诊断平滑肌瘤，阴囊超声是一线非侵入性方法，最终诊断需经组织学检查确认。在组织学上，可见平滑肌束。免疫组化研究可通过识别波形蛋白、结蛋白和平滑肌肌动蛋白等特定标志物来确诊。将平滑肌瘤与恶性的平滑肌肉瘤区分开来很重要。
我们报告了一例罕见的45岁男性阴囊平滑肌瘤病例，经组织学确诊。将平滑肌瘤与恶性病变区分开来很重要。
