A Case Report of Atypical Scrotal Leiomyoma
A 32-year-old man presented with a lump on the right side of his scrotum without any predisposing factors. The lump had been progressively growing in size over the last 3 years. Early on, there were 4–5 soybean-shaped, gray and black, flat wart bands with clustered distribution without exudation and desquamation; however, there was paroxysmal itching or the sensation of ants crawling on the skin. The patient often felt his skin was burning and tingling when the itching was very severe. He self-medicated with Compound Dexa-methasone Acetate cream, Xuanshi solution, and other medications for external use. After such treatment, the itching eased but the rashes slowly expanded. After drinking or using hot water to clean the areas, the urticant ache became worse each time. He had used some medicine containing hydrochloric acid 1 year previously. Then, the topical skin developed ulcers. After the patient took cephalosporin antibiotics, the wound healed and the warts became flat, but the primary sense still remained. To confirm the diagnosis, he visited the hospital. There was no similar history or genetic diseases in his family.\nA physical examination revealed no special abnormalities. A more in-depth examination revealed an approximately 3 × 5-cm2, pink, ill-defined, hyperplastic plaque with an uneven surface, basal infiltration, sheet depigmentation in the center (fig. ), and nearly superficial lymph nodes without palpable enlargement.\nThe skin biopsy showed dermal spindle cells in nodular hyperplasia. The nucleus was round at both ends, a perinuclear halo could be seen, and staining was positive for actin and negative for S100. The combination of HE morphology, immunohistochemistry, and pathology was in line with a diagnosis of scrotal leiomyoma (fig. , fig. , fig. ).