Abstract

1. Abstract
1.1. Background: Leiomyosarcoma is a tumor that can develop in any organ that contains smooth muscles. Although leiomyosarcoma is common, epididymal localization of them is quite rare.
1.2. Objective: To delineate the clinicopatholgic features of epididymal leiomyosarcome and to improve the diagnosis and treatment of this disease.
1.3. Case Presentation: A 79-year-old patient presented with mild pain in the right groin and scrotum for three years followed by a lump at the posterior aspect of the right testis. Ultrasonography and Magnetic resonance imaging (MRI) of the scrotum showed a irregular and heterogenous mass of 4cm×3cm× 4cm at the inferior aspeat of right testis. High inguinal orchiectomy was performed under general anesthesia. Results:The pathological diagnosis was a primary epididymal leiomyosarcoma. Immunohistochemistry showed tumor cells to be positive for smooth muscle action (SMA), desmin (Des), h-Caldesmon, vimentin and EMA and negative for CD34, CD117, PLAP, a-inhibin, ki-67, DOG-1, Myogenin, MyoD, S100 and SOXIO. After the operation, chest and abdominal computed tomography (CT) scans were performed, and tumor markers were detected. No abnormalities were found. He was not planned for any adjuvant therapy.
1.4. Conclusion: Epididymal leiomyosarcome is rare and difficult to diagnose pre-operatively. The final diagnosis of Leiomyosarcoma requires histologic examination. Resection must be extensive and complete. The effect of chemotherapy and radiation on the leiomyosarcoma of the epididymis remains unclear. Recurrence is common, so follow-up is necessary.