Ovarian leiomyoma revisited: a retrospective study of 18 cases with diagnostic and therapeutic implications

This study investigates the clinical characteristics, treatment strategies, and prognosis of ovarian leiomyoma, with the goal of enhancing diagnostic accuracy and therapeutic outcomes for this rare condition. We retrospectively analyzed the clinical data of 18 cases of ovarian leiomyoma in our hospital from 2015 to 2024, including the clinical manifestations, imaging features, treatment and prognosis. The mean age of the patients was 44.78 years. Among them, 88.89% were asymptomatic, with the disease frequently identified incidentally during physical examinations or surgical procedures. Imaging modalities such as ultrasound and MRI demonstrated limited preoperative diagnostic accuracy. Although ovarian tumors were detected in 63.6% of MRI scans, imaging cannot provide a definitive diagnosis of ovarian leiomyoma. Pathological examination remains the gold standard for diagnosing ovarian leiomyoma, with immunohistochemical staining typically positive for smooth muscle markers (ɑ-SMA, desmin). Management is primarily individualized surgical intervention, including either tumor resection with ovarian preservation or adnexectomy, with no recurrence observed in all cases post-surgery. The diagnosis of ovarian leiomyoma remains challenging, as no reliable preoperative examination currently exists to definitively identify this condition. Accurate diagnosis typically requires correlation with postoperative pathological findings. Nevertheless, the prognosis for ovarian leiomyoma is generally favorable.