Inguinal hernia coexisting with spermatic cord leiomyoma

Abstract

Leiomyomas primarily occur in the uterus, small bowel, and esophagus, with occasional instances found in the genitourinary system-bladder, epididymis, prostate, testis, and penis. Among these, scrotal leiomyomas, belonging to genital leiomyomas, present as solitary growths within scrotal structures, displaying gradual growth. Specifically, spermatic cord leiomyoma is exceptionally rare, with limited cases since the 1950s. A 63-year-old male exhibited persistent left groin pain and swelling, initially suggesting a hernia. Examination revealed an inguinal hernia and a palpable, mobile 3 cm solid mass. Ultrasonography identified a well-defined solid hypoechoic lesion. Magnetic resonance imaging (MRI) displayed a 37x24 mm ovoid lesion, hinting at its origin from the spermatic cord. Surgical intervention involved hernia repair and mass excision, confirming leiomyoma via histopathology. Spermatic cord leiomyomas, rare and hernia-mimicking, highlight the crucial role of MRI in accurate preoperative diagnosis, emphasizing the need to consider leiomyoma in inguinal mass differentials.