Paratesticular leiomyosarcoma originates from testicular tunica (48%), spermatic cord (48%), epididymis (2%) and dartos muscle, as well as subcutaneous tissue of the scrotum (2%). Leiomyosarcomas of the scrotum, not involving the testis, epididymis or spermatic cord, are rare, and belong to the group of subcutaneous superficial leiomyosarcomas. To the knowledge of the authors, less than 10 cases of leiomyosarcoma of the scrotum have so far been reported from India. The tumor usually presents as a painless, slow-growing scrotal mass in middle-aged or elderly men. The current approach is wide local excision, often with adjuvant therapy. The prognosis is usually good following complete excision, though a local recurrence rate of 40% has been reported. Long term follow-up is, therefore, necessary to monitor for recurrence. Herein we present the case of 35-year-old male who presented with an exophytic scrotal mass. Histopathological and immunohistochemical findings of the mass were consistent with leiomyosarcoma.
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