Myxofibrosarcoma is a rare malignant soft tissue tumor, most commonly affecting the extremities of elderly individuals. Paratesticular involvement is extremely uncommon and often presents a diagnostic challenge. We present the case of a male patient who presented with a painless, progressively enlarging right-sided scrotal swelling of 4 years’ duration. Clinical examination revealed a large scrotal mass with a non-palpable right testicle. Imaging and histopathological evaluation confirmed the diagnosis of paratesticular myxofibrosarcoma. We will mainly discuss the clinical presentation, imaging findings, and pathological features of this rare tumor.

Myxofibrosarcoma

Paratesticular tumor

Scrotal mass

Magnetic resonance imaging

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