Neurofibroma is a benign tumor of the nerve sheath originating from the Schwann cells. They are commonly seen in the neck, thorax, cranium, retroperitoneum, and flexure aspects of the upper and lower extremities.[3
] Neurofibroma of scrotum in the absence of NF I is extremely rare and to the best of our knowledge, about 10 cases  have been reported in the English literature so far.[2
] Solitary scrotal neurofibroma of the scrotum has been reported in a wide range of ages, mostly presenting with painless or painful swelling of the scrotal area.[4
The clinical characteristics of the reported scrotal neurofibromas in the English literature
Our case was a 52-year-old man who presented with painless swelling of the scrotal area. There was no stigmata of NF I, although no genetic study was available for confirmation.
In most cases of scrotal neurofibroma, the exact origin of the tumor cannot be determined, but overall the majority of them are extratesticular.[4
] Some have been originated from tunics, epididymis, subcutaneous neural tissue, and spermatic cords.[8
] In our patient, during surgery, the bulk of tumor has been attached to the spermatic cord, so the most probable origin of the tumor might be genitofemoral or the ilioinguinal nerve or even smaller nerve axons.[10
This type of tumors can be solitary or multiple. Multiple neurofibromas are mostly in favor of NF I and investigations should be targeted toward the other signs of this syndrome such as café-au-lait macules, sphenoidal dysplasia, Lisch nodules, and optic glioma.[1
] The histopathologic features of the mass did not show plexiform neurofibroma which is seen classically in NF I. Meanwhile, all of the previously reported scrotal neurofibromas in the patients with NF type I are part of genitourinary neurofibromatosis involving urethra, penis, and perineum.[11
] Thorough investigation including imaging studies did not reveal any stigmata of NF I. Therefore, the mass was considered as solitary neurofibroma of scrotum most probably originating from the spermatic cord.
Treatment of choice in these tumors is excision. Frozen section diagnosis is very helpful in this regard to exclude malignancy avoiding orchiectomy.[5
In conclusion, scrotal neurofibroma is a rare benign tumor which should be considered in the differential diagnoses of scrotal masses that are extratesticular in origin.