Journal of Surgical Oncology 28:318-320 (1985)

Leiomyoma of the Spermatic Cord

DEBA P. SARMA, MD, AND T H O M A S G. WEILBAECHER, MD

From the Department of Pathology, Louisiana State University Medical School and Veterans Administration Medical Center, New Orleans

A case of leiomyoma of the spermatic cord is described, and the English literature is reviewed.

KEY WORDS: leiomyoma of spermatic cord, spermatic cord tumor, benign neoplasm of spermatic cord, rare tumor of spermatic cord

INTRODUCTION CASE REPORT Leiomyoma of the spermatic cord is very rare. About A 53-year-old black man with cirrhosis of liver, jaun-

ten cases have been reported in the literature [Belis et al, dice, and ascites was noted to have a firm, nontender 19791. We describe an additional case and review seven right scrota1 mass on physical examination. He had no reported cases from the English literature. complaints regarding the scrota1 mass that had been pres-

Fig. 1. Gross specimen showing whorled and lobulated surface.

Accepted for publication May 2, 1984. Address reprint requests to Deba P. Sarma, MD, VA Medical Center, 1601 Perdido Street, New Orleans, LA 70146.

0 1985 Alan R. Liss, Inc.

Spermatic Cord Leiomyoma 319

Fig. 2. Photomicrograph showing intertwining bundles of smooth muscle. H&E, X 100.

McCook, 1942 [5]

Strong, 1942 [6]

Zuckner and Aronberg, 1951 [7]

Bormel and Younger, 1961 [2]

Dougall and Wilson, 1969 [4]

Deluise et al, 1976 [3]

Belis et al, 1979 [ l ]

Sarma and Weilbaecher, 1984

Black man, aged 66. Gradually increasing painless right scrotal mass, I year

One-hour-old premature child with hypospadius, congenital malformation of heart and partially descended testis

White man, aged 72. Left inquinal mass, 7 years. The excised tumor was a myxolipofibroma. Six years later another firm, nontender, slowly growing left scrotal mass was excised

Black man, aged 58. Enlarging, painless right scrotal mass, 8 months

Man, aged 39. Gradually enlarging, painful left scrotal mass

White man, aged 58. Painful right testicular mass, 1 year

White man, aged 55. Painless left scrotal mass of

Black man, aged 53. Asymptomatic right scrotal mass unknown duration

Ovoid, circumscribed, 10-cm mass with nodular

Autopsy showed bilateral leiomyoma of the cord situated above each testis, equal in size to the testis

cm with whorled cut surface

cut surface

Encapsulated, rubbery, mass, 4.5 X 3.5 X 3

Solid, pearly white mass, 15 X 19 cm, weighed

Encapsulated, 4.5 X 2.5 X 3 cm, cut sections

Two spermatic cord leiomyomas, 4.5 X 3.5 cm

1,575 gm. Encapsulated

resembling uterine fibromyoma

and 5 x 3 cm. There was a third 1.2-cm lipoma in the cord

deferens A 4-cm leiomyoma arising from the vas

A 3-cm encapsulated mass with lobulated and (Present case) present for unknown duration whorled cut surface

320 Sarma and Weilbaecher

ent for an unknown length of time. Ultrasound evaluation revealed a well-circumscribed solid tumor mass located separately and superiorly to the right testicle and medi- ally to the right spermatic cord. The left scrotal contents were normal. Results of routine urinalysis were normal.

On inguinal exploration, the mass was completely sep- arate from the testicle and epididymis and was lying adjacent to the spermatic cord. It was easily excised. The 3-cm encapsulated mass (Fig. 1) showed a somewhat lobulated and whorled cut surface. Microscopically (Fig. 2), the tumor was composed of bundles of smooth mus- cles. Ultrastructural studies also confirmed the nature of the tumor as a leiomyoma.

Postoperative course was uneventful.

DISCUSSON Table I lists the essential features of seven reported

cases collected from the English literature and one addi- tional case from the present communication.

The reported patients were of all ages ranging from newborn to seventh decade. There was no racial prepon- derance. Though a few patients were asymptomatic, most

of the others presented with gradually increasing, pain- less, or painful scrotal mass. Leiomyomas developed in either right or left spermatic cord with almost equal frequency. All reports described a unilateral lesion ex- cept for one case of bilateral leiomyomas occurring in a newborn. Most of the patients had single tumors varying in size form a few to 19 cm and weighing up to 2,575 gm. Surgical excision of the tumor itself or along with orchiectomy was the curative therapy.

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Belis JA, Post GJ, Rochman SC, Milam DF: Genitourinary leiomy- omas. Urology 13:424429, 1979. Bormel P, Young JD: Leiomyoma of the spermatic cord. J Urol

Deluise VP, Draper JW, Gray GF: Smooth muscle tumors of the testicular adnexa. J Urol 115:685-688, 1976. Dougall AJ, Wilson RR: Leiomyoma of the vas deferens. Br J Urol41:348-350, 1969. McCook WW: Leiomyoma of the spermatic cord. Am J Surg

Strong GH: Lipomyxorna of the spermatic cord: Case report and review of literature. J Urol48527-532, 1942. Zuckner J , Aronberg LM: Leiomyoma of the spermatic cord with the report of a case. J Urol 66:285-288, 1951.

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