Leiomyoma is a relatively uncommon neoplasm of the epididymis derived from smooth muscle cells. A case of primary leiomyomas simultaneously occurring in both epididymides is reported in a 58-year-old man, clinically presenting painless intra-scrotal masses. The examination of the epididymis characterizes clinically by a firm solid, well-circumscribe mass, and histological spindle cells arranged in interlacing bundles with varying admixtures of fibrous and hyalinized connective tissue. Clinical, histopathologic and immunohistopathologic features, with briefly reviewed relevant literatures describing 7 cases of bilateral leiomyoma of epididymides are discussed. The patients with the mean age of 56.6 years (range 47-62 years) had epididymal mass measuring 5 to 75 millimeters (mean 21.3 millimeters). This is the first reported description of bilateral leiomyoma of epididymides in Thailand.
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