Primary testicular leiomyosarcoma

Primary leiomyosarcoma of the testis is a rare condition with only 13 cases reported. We present a case of primary intra-testicular leiomyosarcoma in a 45 year old patient who presented with painless testicular enlargement. Ultrasound revealed a large heterogeneous right testicular solid mass with moderate hydrocele and huge retroperitoneal mass. Serum alpha-fetoprotein (AFP) and beta-human chorionic gonadotrophin (β-HCG) were normal. A right radical orchidectomy with histopathology confirmed primary leiomyosarcoma of testis. A leiomyosarcoma should be one of the differential diagnosis of a sero-negative testicular mass.