Symplastic scrotal leiomyoma: a case report.
BACKGROUND
Scrotal leiomyomas are rare tumours which are essentially benign. Recurrence and malignant transformation to leiomyosarcoma have been reported. However, a specific subgroup with increased bizarre nuclei showing increased mitosis raises the need for a closer follow-up. We report on such a case.


METHODS
We report the case of a 65-year-old man who underwent a scrotal lump excision. Histology showed a well defined leiomyoma. The presence of nuclear pleomorphism and mitoses, just falling short of the criteria for malignancy, made prediction of biological behaviour difficult. The patient remains well on 4-year follow-up.


CONCLUSIONS
Histological evidence of increased mitosis raises the need for sustained follow-up in view of the malignant potential from the extent of mitosis. Immunohistochemistry helps in identifying those patients warranting close follow-up.
Philip
Joe
J
Department of Urology, Royal Cornwall Hospital, Truro, UK. indianajoe@gmail.com
Manikandan
Ramaswamy
R
Vishwanathan
Palaniswamy
P
Mathew
Joseph
J
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