Leiomyomas are uncommon benign tumors of the genitourinary system that can mimic benign scrotal lesions such as sebaceous cysts. A 56-year-old male with a 20-year history of a painless scrotal swelling. It was hard, irregular, non-tender swelling in lower midline of scrotum, distinct from both testes and spermatic cords. He underwent complete surgical excision of a 4 x 5cm lesion. Histopathology confirmed a benign leiomyoma without atypia or any mitotic activity. There was no recurrence at 1 year follow-up. Scrotal leiomyomas is one of the differentials in a long-standing scrotal swelling. Surgical excision is both diagnostic and curative. • Scrotal leiomyoma can be one of the differential of chronic scrotal lesions in middle aged men. • It is necessary that histopathologist performs a careful assessment for the any subtle feature of malignancy. • Conservative management recommended initially and surgical excision can be considered when increasing in size or becomes symptomatic.
Seetlani et al. (2026) studied this question.