Primary ovarian leiomyoma

Abstract

Leiomyoma is a common benign mesenchymal tumor that can develop wherever
smooth muscle is present; rare as a primary ovarian tumor, its origin is still
controversial. Primary ovarian leiomyoma is one of the rarest benign ovarian tumors,
accounting for 0.5% - 1% of benign tumors and is usually seen in women between 20
and 65 years of age. They are usually asymptomatic and appear incidentally during
a pelvic examination or surgery for another cause but can occasionally manifest by
abdominal pain and palpable mass. Definitive diagnosis is difficult before surgical
removal. Because there are no pathognomonic symptoms and no characteristic
imaging, the main differential diagnoses include fibroma, thecoma, sclerosing
stromal tumor and leiomyosarcoma. Immunohistochemical staining is essential for
accurate diagnosis and should be considered in the differential diagnosis of ovarian
spindle cell tumors. A case of primary ovarian leiomyoma is presented.