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Penis and scrotum

Neoplastic lesions of scrotum

Leiomyoma

 

Editors: Antonio Cubilla, M.D. and Alcides Chaux, M.D. (see Author/Reviewers page)

Revised: 22 May 2010, last major update May 2010

Copyright: (c) 2002-2010, PathologyOutlines.com, Inc.

 

Definition

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● Rare in scrotum, similar to counterpart elsewhere

● ICD-O: 8890/0

 

Terminology

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● Scrotal leiomyomas are classified as leiomyoma cutis (originates in skin) or dartoic leiomyoma (originates in tunica dartos)

● Scrotal leiomyoma cutis can be further subclassified as pilar leiomyoma (originates in adnexal smooth muscle) or angioleiomyoma (originates in vascular smooth muscle)

 

Epidemiology

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● Rare; one case per 1000 scrotal tumors (J Urol 1976;116:69)

 

Clinical features

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● May clinically resemble a cyst

● Firm to hard rubbery painless mass

● Rarely polypoid or ulcerated

● Epithelioid features, myxoid change and hyalinization are much less common than in vulvar lesions (Histopathology 1991;18:523)

 

Treatment

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● Conservative; local excision

 

Gross description (Macroscopy)

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● Tumor size 0.2-3.0 cm

 

Gross images

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Tan-gray cut surface

with whorling

 

Micro description (Histopathology)

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● Circumscribed, non-encapsulated proliferation of spindle-shaped cells with smooth muscle features arranged in fascicles

● Smooth muscle fascicles separated by variably collagenized stroma

● Bizarre, atypical and symplastic changes in some cases (see leiomyoma with bizarre nuclei)

● Rarely myxoid changes and lymphoid aggregates

● No necrosis, no/rare mitoses

● Overlying skin is without epithelial alterations

 

Micro images

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Leiomyoma of dartos has smooth muscle bundles separated by collagenous stroma

 

 

Thumbnail: Figure 1: Scrotal biopsy, low magnification.                                Thumbnail: Figure 2: Scrotal biopsy, high magnification

Bundles and fascicles of smooth muscle cells with eosinophilic fibrillar cytoplasm and elongated nuclei with blunted ends

 

 

                               

Well circumscribed tumor               Interlacing bundles

delineated from skin

 

Positive stains

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● Smooth muscle markers desmin, alpha smooth muscle actin; also vimentin

● Also androgen receptors (J Cutan Pathol 2007;34:946)

 

End of Penis and scrotum > Neoplastic lesions of scrotum > Leiomyoma

 

 

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