Epididymal leiomyoma

Last revised by Dr Jeremy Jones on 20 Sep 2021

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.

  • slowly-growing nontender scrotal mass
  • more common at age 40 and older 
  • solid, well circumscribed usually hypoechoic mass centered in the epididymis
    • may also be cystic or calcified 3
  • 1-4 cm in size
  • homogeneous low signal intensity on T1- and T2-weighted images

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