Ileal leiomyoma disguised as intussusception: Imaging pitfalls in a 28-year-old female

Leiomyomas are benign mesenchymal tumors that commonly occur in uterus and rarely in gastrointestinal tract with esophagus being the most frequent site followed by stomach and colon. Duodenal leiomyoma is rarest of all with ileal leiomyoma being the second rarest. This report discusses a case of a 28-year-old female with an enlarging lower abdominal mass post-hysterectomy, initially misinterpreted as an adnexal tumor based on imaging. Various diagnostic modalities, including ultrasound, CECT, and MRI, provided conflicting interpretations, complicating preoperative assessment. Exploratory laparotomy confirmed an intraluminal ileal leiomyoma, highlighting the importance of integrated imaging and histopathological evaluation for accurate diagnosis. Genetic studies indicate associations with syndromic conditions like NF1 and Reed syndrome, emphasizing the need for vigilant surveillance and potential molecular-targeted therapies. While traditionally managed surgically, emerging research suggests epigenetic modifications may play a role in tumor behaviour and therapeutic advancements.