Scand J Urol Nephrol 25: 79-80, 1991

BILATERAL LEIOMYOMA OF T H E TUNICA ALBUGINEA Case Report

G. Aus and P. T. Boiesen Departments of Urology and Pathology, Ryhovs Hospital, Jonkoping, Sweden

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(Submitted April 6 , 1990. Accepted for publication April 21. 1990)

Abstract. A 64-year-old man presented with difficulty in passing urine. He was found to have two benign tumours, one in the lower pole of each testis, and a carcinoma of the prostate (all confirmed histologically). He was given no treatment initially but when his prostatic cancer showed signs of progression he underwent bilateral orchidectomy. Benign scrotal tumours are relatively rare, and this might be the first case of bilateral leiomyoma in the tunica albuginea.

Key words: scrotal tumour, leiom yoma, tunica albuginea.

CASE REPORT A &4-year-old man was referred to the department of urology because of difficulty in passing urine. On rectal examination his prostate felt malignant. He also had firm.

smooth, opaque tumours measuring about 2.5 cm in diameter at the lower poles of both testes. The diagnosis of prostatic cancer was confirmed by fine needle aspiration biopsy. Because of the mildness of his symptoms, normal acid phosphatase activity, and normal bone scan, no treatment was started, and he was followed up for 18 months. At this time his prostatic carcinoma began to progress locally, he developed further difficulties in passing urine. and the acid phosphatase activity increased. The two tumours of the testes were unchanged. He was treated by bilateral orchidectomy through a scrotal incision. The two tumours apparently originated from, or were intimately related to, the testes. Gross inspection of the specimens showed bilateral firm masses of the tunica albuginea. On microscopic examination the tumours consisted of smooth muscle cells and fibrous tissue with no signs of malignancy (Figs. I and 2). The testes and epididymis were otherwise normal. The

Fig. I . Peripheral part of leiomyoma close to epididymis (top right). Van Gieson-Hansen ~ 2 5 . Scand J Urol Nephrol25

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G . Aus and P. T . Boiesen

Fig. 2. Detail of leiomyoma with smooth muscle cells

arranged in whorls and interlacing bundles. Van GiesonHansen ~ 4 5 .

findings were consistent with the diagnosis of bilateral leiom yoma.

in association with the testis. To make a definite diagnosis and exclude malignancy exploration may be required.

DISCUSSION Leiomyomas are rarely found in the urinary tract. Most cases described are in the renal capsule. Localisation in the tunica albuginea has to our knowledge been reported only three times previously (1, 2, 3). This may be the first case of bilateral tumours. This type of turnour should be suspected in cases in which an opaque, smooth, tumour is found

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REFERENCES 1. Albert PS, Mininberg DT. Leiomyoma of the tunica

albuginea. J Urol 1972; 107: 869-871. 2. Chiaramonte RM. Leiomyoma of tunica albuginea of testis. Urology 1988; 31: 346345. 3. Mora A. Leiomioma della tunica albuginea. Urologia 1979: 46: 768-171.

Bilateral leiomyoma of the tunica albuginea. Case report.

A 64-year-old man presented with difficulty in passing urine. He was found to have two benign tumours, one in the lower pole of each testis, and a car...
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