• Dajiang Lu, Hua Chen, Chengfang Yang, Yanzhen Liu, Haishan Mo, and Yongguo Zhang.
• Department of Gynecology, the People's Hospital of Qiannan, Duyun, Guizhou, P.R. China.
• Medicine (Baltimore). 2024 Jul 26; 103 (30): e39122e39122.

RationalePrimary ovarian leiomyoma is a rare benign tumor. The exact histological origin and pathogenesis of primary ovarian leiomyoma are still unclear, while its preoperative imaging diagnosis is often challenging and prone to misdiagnosis. The study aims to elucidate the diagnosis of primary ovarian leiomyoma and to distinguish it from fibroma.Patient ConcernsA 34-year-old female was admitted to the hospital with complaints of pelvic mass found for one year. One years ago, the patient went to a local hospital for examination due to irregular menstruation.DiagnosesThe ultrasound report of the patient showed ovarian teratoma. The postoperative pathological results showed ovarian leiomyoma and calcification.InterventionsThe patient underwent laparoscopic right ovarian leiomyoma resection.OutcomesThe patient was discharged home three days after surgery. At the most recent follow-up (five months after operation) of the patients, ultrasound was performed and no abnormal echoes were suggested in the adnexal region.LessonsIn the diagnosis of primary ovarian leiomyoma, our case emphasizes the importance of microscopic features as an effective approach to distinguish it from ovarian fibroma, leiomyosarcoma, and stromal tumors. Additionally, personalized treatment should be considered based on the patient age and fertility needs.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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