Leiomyosarcoma of the epididymis: 2 cases and review of the literature

Paratesticular leiomyosarcomas are rare. We report two cases ofleiomyosarcoma of the epididymis diagnosed and treated in aregional community hospital in Canada in 2009 and 2010. Bothpatients were males of ages 58 and 75, respectively. They presentedwith painless masses which, on ultrasonography, appeared to besolid masses demonstrating blood flow. Each patient underwenttrans-scrotal resection of the affected epididymis. Pathologicalexamination of trans-scrotal epididymectomy specimens confirmedthe diagnosis of high-grade leiomyosarcoma. Leiomyosarcoma isan important differential diagnosis for paratesticular masses in theelderly male; the primary treatment is radical inguinal orchiectomywith high ligation of the spermatic cord.