RESUMO
Primary leiomyosarcoma of the testis is a very rare tumor with only 9 reported cases in the English literature, of which none has been reported in patient of African descent. In this report we described the first case of a massive primary leiomyosarcoma of the testis. A 20-year-old-man presented with huge fungating tumor of the left scrotum with no clinical or imaging evidence of regional or distance metastasis. Left radical orchiectomy was performed, followed by satisfactory postoperative recovery. The postoperative histopathology examination and Immunohistochemistry for desmin, actin, vimenten, and S-100 indicate primary leiomyosarcoma of the left testis. Eleven month later the patient developed convulsion episodes. Brain CT scan and MRI showed brain metastatic deposition. Abdominal ultrasound indicates involvement of paraaortic lymph nodes. The patient received 5 cycles of vincristine, actinomycin D, and cyclophosphamide in addition to Epanutin 50 mg three times a day. However, Twenty two month after surgery the patient underwent another surgery for local recurrence. The present case showed aggressive course of primary testicular leiomyosarcoma in contrast to the benign course previously reported. In addition to radical orchiectomy with high ligation of the spermatic cord, systemic chemotherapy, and regional radiotherapy may be the treatment of choice for some primary leiomyosarcoma of the testis