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A 12-month-old boy presented with left scrotal swelling. The mass was irregular, soft, fleshy, and nontender. It adhered to the scrotal skin and gradually enlarged. Operative findings revealed a mass fixed to the scrotal fundus and diagnosed as angiomyolipoma. This is apparently the first report of scrotal angiomyolipoma in infancy.

Based on standard histological methods and specific injection technique, the study demonstrates for the first time the blood vessel system of the scrotal integument.The latter is relatively thin and shows a thick underlying fascia, the tunica dartos. The vessel networks found in both structures are somewhat different from each other, i.e., the former displays the typical integumental vessel scheme, which, because of its thinness, shows a higher vessel density. The tunica dartos displayed a blood vessel system with specific characteristics, i.e. horizontal networks are present, which are on the one hand directly connected to the rete dermidis and on the other hand, with the ascending (arteries) or descending (venes) vessels of the dartos, so that a rather uniform distribution and nutrition of the latter, including its muscle layers, is assured.The findings support the idea that the functions of the scrotal integument and the dartos are based on a dependable energy supply, but with regard to vessel type, particularly arteries, may also be involved in the regulation of blood flow. Thus, the scrotal integument as well as the dartos can be used for thermoregulation.

A variety of neoplasms derived from mesechymal elements may arise on the tunica dartos, the tunica albuginea or, more rarely, within the testis or the epididymis. The authors report a case of leiomyoma of the scrotum in a 33-year-old man. This rare and benign tumour is localized in the tunica dartos in 8% of cases. The positive diagnosis is based on histological examination after conservative treatment by local excision which gives excellent results.

Six dartos musculocutaneous flaps have been used to resurface proximal penile defects. The vascular anatomy of the flap, surgical technique and complications are described in detail.

Leiomyoma may originate at any anatomic location of smooth muscle in the genitourinary system. The kidney capsule is the most common site for the genitourinary leiomyomas. Leiomyoma origination from the scrotum is rare. The previous reported cases presented as small, firm, nontender, slowly enlarging freely movable masses within the scrotum. We report a case of leiomyoma of the tunica dartos, a benign lesion arising from the wall of the left scrotum. It presented as a pedunculated lesion with a surface ulceration, which need to be differentiated from squamous carcinoma of the scrotum. It was treated with a simple surgical excision.

Leiomyoma is a benign tumor derived from smooth muscle. Leiomyoma of the scrotum arising from the tunica dartos is exceedingly rare. We describe the case of a 51-year-old Japanese man with this disease entity.

We report a case of acquired smooth muscle hamartoma (ASMH) of tunica dartos, believed to be only the fifth so far reported. A 24-year-old man had a 6-month history of an asymptomatic tight and thickened scrotum. The skin was difficult to pinch. A biopsy specimen from the skin showed increased and proliferated smooth-muscle bundles composed of well-differentiated and uniform spindle cells that showed typical features of acquired smooth muscle hamartoma. Interestingly, dilatations of the lymph vessels were noted in the upper dermis above the proliferated smooth muscles. It has been reported recently that long-standing severe lymphoedema may cause histological features mimicking ASMH. As the present case was not preceded by oedema of the scrotum, we consider this case to be true ASMH.

Scrotal leiomyomas of the tunica dartos are extremely rare and usually misdiagnosed. A case of a pedunculated mass observed expectantly over thirty years demonstrates the benign oncologic natural history of this lesion despite its capability for substantial growth. Only limited local surgical management of such lesions is indicated.

Scrotal leiomyomas with atypical bizarre nuclei are rare, which might be misdiagnosed as malignant tumor. We describe a case of scrotal bizarre leiomyoma in a 65-yr-old man. The tumor was a 1 cm-sized, well circumscribed, oval mass arising from the tunica dartos muscle. Histologically, it was formed by whorling bundles of fusiform cells with occasional atypical, pleomorphic nuclei and pseudo-inclusions. Mitosis was not found. Although morphologically atypical, scrotal bizarre leiomyomas take on a biologic behavior not different from that of conventional leiomyoma, they should be distinguished from leiomyosarcoma to avoid unnecessary treatment.

Of 127 patients with primary neoplasms of the scrotal wall 10 had a solitary leiomyoma arising from the tunica dartos. These benign asymptomatic lesions occur in middle-age white men and are often incorrectly diagnosed. Simple surgical excision is curative. The 11th case is described because of the malignant course that followed irradiation. A cell arising from single smooth muscle cells within the corium is proposed as the cell of origin.

A case of leiomyoma of the tunica dartos, a benign lesion arising from the wall of the scrotum and not attached to the epididymis, testicular tunics, or adjacent structures, is presented.

Leiomyomas arising from the tunica dartos scroti are rare tumors. We report the first case of bilateral leiomyomas of the scrotum.

A comparison was made of evaporative heat loss from the skin of the scrotum and the thorax of the bull. The sweat glands of the scrotum were not controlled independently of those on the general body surface. Scrotal sweat glands were found to be under adrenergic neural control like those of the general body surface. The large sweat glands of the scrotum produced approximately five times as much sweat per gland as those on the general body surface. Localized heating of the scrotum for 20 min stimulated both panting and sweating without any change in deep body temperature. Insensible moisture loss from the scrotum was greater than that from the skin of the general body surface. It is concluded that there are no fundamental differences in the properties of the sweat glands of the scrotum and those of the general body surface, and that the high insensible moisture loss of the scrotum assists with cooling of the skin of the scrotum. It is suggested that a function of the tunica dartos muscle is to reduce insensible moisture loss.