Primary ovarian leiomyoma: a diagnostic dilemma

Primary ovarian leiomyoma is an uncommon entity accounting for 0.5-1%of all tumors and 4% of all the ovarian neoplasms. Ovarian leiomyoma is a benign, smooth muscle, solid tumors that occur in women aged 20-56 years. Because of its benign nature the prognosis for patient is good. A case of primary ovarian leiomyoma in a pre-menopausal female is to be presented here. A 49 years old female, married for 24 years came to gynaecology out-patient department with complaints of lower abdominal pain and abnormal uterine bleeding without dysmenorrhea and soakage of 4-5 pads per day since 1 month. On per abdomen examination non-tender firm to hard mass of 16 weeks gravid uterus size with regular margins, per speculum examination revealed cervicitis, per vaginal examination revealed the same mobile mass in left fornix and the uterus found to be normal size and to be deviated toward right side. CA-125 level found to be 10.71 and ultrasonically an ovarian mass of size 10×8×4 cm was revealed. The decision of total abdominal hysterectomy with bilateral salpingo-oophorectomy was taken. The histopathology of ovarian mass confirmed to be the diagnosis of primary ovarian leiomyoma. This report highlights a case of primary ovarian leiomyoma in a pre-menopausal woman with a postoperative pathology report as a definitive diagnosis.