Epididymal leiomyoma

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Epididymal leiomyomas (fibrous pseudotumors) are uncommon smooth muscle tumors that do not have malignant potential. Their imaging features are not specific and, if small, it may be a difficult prospective diagnosis on imaging. They are usually encountered in a differential for epididymal/paratesticular masses and are the second most common epididymal mass, after adenomatoid tumors.

Clinical presentation

  • slowly-growing nontender scrotal mass
  • more common at age 40 and older 

Radiographic features

Ultrasound
  • solid, well circumscribed usually hypoechoic mass centered in the epididymis
    • may also be cystic or calcified
  • 1-4 cm in size
MRI
  • homogeneous low signal intensity on T1- and T2-weighted images

Differential diagnosis

See also