Leiomyoma of the bilateral testicular tunica albuginea is extremely rare. To our knowledge, there are only 3 definitely reported cases. This is the first report of bilateral testicular tunica albuginea leiomyomas as a potential cause of male infertility. Herein, we report a case of a 47-year-old man who presented with painless bilateral testicular masses for more than 30 years, besides he also suffered from unexplained infertility. The complete resection of the tumors was performed. The final pathological diagnosis was leiomyomas of the bilateral tunica albuginea. Postoperatively, the patient underwent testicular biopsy. Histopathology confirmed moderate atrophy of bilateral testes, and the number of spermatogenic cells in the seminiferous tubules were significantly decreased. In this case, bilateral testicular dysplasia is the root reason for the patient's infertility. Thus, despite the benign nature of bilateral testicular tunica albuginea leiomyomas, they may cause bilateral testicular hypoplasia and infertility in men. In the case of men with fertility requirements, early local mass excision is often necessary.
Keywords: Leiomyoma; infertility; testicular dysgenesis; tunica albuginea.