Primary Ovarian Leiomyoma: A Common Tumor at an Uncommon Site

Primary ovarian leiomyoma is a very rare benign tumor accounting for 0.5%-1% of all the benign ovarian neoplasms. The most common presentation is unilateral, small masses discovered incidentally on radiology, predominantly occurring in premenopausal women of age group 20-65 years. A 49-year-old woman presented with pain in the abdomen and abnormal uterine bleeding. Ultrasonography showed a heterogeneous, hypoechoic solid mass of size 10.4 cm × 6.4 cm × 7.7 cm arising from fundus. The patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy. Histological examination revealed a leiomyoma arising primarily in the right ovary. The diagnosis was confirmed immunohistochemically. Ovarian leiomyoma, a rare tumor of the ovary, should be considered in the differential diagnosis of solid ovarian masses, which display gross anatomical and histological similarities. An immunohistochemical analysis is essential for definitive diagnosis. Herein, we report a case of unilateral ovarian leiomyoma in a premenopausal woman.