A huge acquired smooth muscle hamartoma of the scrotum

Smooth muscle hamartoma (SMH) is a rare benign proliferation of the smooth muscle. It usually arises on the back and proximal extremities, although it develops on the scrotum in rare cases. Here, we present a 58-year-old man who presented with a huge mass of the scrotum, which was first noticed 10 years previously. The scrotum was considerably enlarged and affected the patient’s gait. We performed wide excision of the mass, measuring 32.5 × 20 × 14 cm in size and weighing 3600 g. The residual uninvolved scrotal skin flap was well vascularised and elastic, and the testis could be properly contained within the scrotum after primary closure of the defect. A split-thickness skin graft was used to resurface the skin defect of the penile shaft. The patient was satisfied with the shape and texture of the scrotum after reconstruction. The postoperative course was uneventful. We assess our experience in the successful reconstruction of a large penoscrotal skin defect using a scrotal skin flap and split-thickness skin graft. This procedure is safe and uncomplicated with the patient regaining a normal genital contour and satisfactory functional recovery.