Abstract
Introduction: Leiomyomas are benign smooth muscle tumors most commonly originating from the uterus, but on rare occasions, they can develop in extra-uterine sites. Such atypical presentations may complicate preoperative diagnosis, particularly when mimicking other adnexal pathologies. We report a rare case of an ovarian leiomyoma presenting as an acute abdomen, highlighting the diagnostic and surgical challenges encountered.
Case Description: A reproductive-aged woman presented with sudden-onset severe lower abdominal pain and clinical features consistent with an acute abdomen. Imaging revealed an adnexal mass with features suggestive of ovarian torsion. Emergency laparotomy identified a solid mass inseparable from the ovary. Salpingo-oophorectomy was performed. Gross and histopathological examination confirmed the diagnosis of an ovarian leiomyoma with torsion.
Conclusion: Although ovarian leiomyomas are rare, they should be considered in the differential diagnosis of solid adnexal masses, especially in cases presenting with acute abdomen. Preoperative differentiation from other ovarian tumors is challenging, and definitive diagnosis relies on histopathology. Prompt surgical intervention remains crucial to prevent complications related to torsion and ischemia.
Keywords
Leiomyoma, Acute abdomen, Parasitic leiomyoma