Unilateral primary ovarian leiomyoma in adolescent: a case report

Case Report: Primary Ovarian Leiomyoma: A Clinical Analysis of Case Series and Literature Review

Ovarian leiomyoma accounts only for 0.5–1% of all benign ovarian tumors, and almost no preoperative diagnosis has been achieved. Commonly, these tumors are small in size and asymptomatic. However, they can become symptomatic as their size increases; thus, it is important to recognize this entity and differentiate them from ovarian malignant tumors. Radical surgeries with total hysterectomy and salpingo-oophorectomy are usually performed. However, ovary-preserving surgery has been suggested to young women, especially those desiring fertility in the future. In this study, we shared seven cases of primary ovarian leiomyomas and one inherent ligament leiomyoma, reviewed related articles to provide some new information about leiomyoma of the ovary, and discussed their proper surgical management.

Symptomatic Primary Ovarian Leiomyoma in a Postmenopausal Woman: A Rare Entity

Leiomyomas are benign mesenchymal neoplasms mostly seen in the uterus and are one of the most common pelvic masses seen in women, but primary ovarian leiomyomas are rare among all the benign ovarian tumors, which account only for 0.5%–1%. The definitive diagnosis of such lesions is difficult prior to surgical excision, as there are no pathognomonic symptoms or characteristic imaging findings. Here, we report a case of primary ovarian leiomyoma with brief review of literature, highlighting the differential diagnosis of ovarian spindle cell lesions. The correct diagnosis of an ovarian leiomyoma requires identification of the nature of tumor as smooth muscle. An immunohistochemistry marker analysis is recommended for definitive diagnosis.

Primary ovarian leiomyoma in a postmenopausal woman: A case report

Leiomyomas are benign neoplasms that can develop wherever smooth muscle is present. Primary leiomyomas of the ovary originate from smooth muscle cells of ovarian tissue and are rare, solitary tumors. Approximately 70 cases have been reported. They usually present in premenopausal women. The present case is a report of left ovarian leiomyoma in a postmenopausal woman.

Primary ovarian leiomyoma: A case report

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Primary ovarian leiomyoma is one of the rarest solid tumours of the ovary.

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Many patients with ovarian leiomyomas are nulligravidas.

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Differential diagnosis can be difficult from ovarian solid tumours.

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The diffuse strong positive staining for SMA is characteristic of leiomyoma.

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Unilateral and benign tumours can be treated with unilateral salpingo-oopherectomy.

INTRODUCTION

Primary ovarian leiomyoma is a rare benign tumour of the ovary seen in women between 20 and 65 years old. It is usually diagnosed incidentally during pelvic examination or pathologic examination after surgery.

PRESENTATION OF CASE

We describe a case of unilateral, ovarian leiomyoma. Transvaginal ultrasonography and magnetic resonance imaging (MRI) revealed a right adnexial mass. Unilateral salpingo-oophorectomy was performed, and histological examination revealed a leiomyoma arising primarily in the ovary. The diagnosis was confirmed immunohistochemically.

DISCUSSION

The tumour may be asymptomatic or may manifest with lower abdominal pain like in our case. The definitive diagnosis of these lesions is difficult prior to surgical removal. Because there is no pathognomonic symptoms or characteristic imaging findings. The correct diagnosis of an ovarian leiomyoma requires identification of the smooth muscle nature of the tumour.

CONCLUSION

This rare tumour of the ovary should be considered in the differential diagnosis of solid ovarian masses. An immunohistochemical analysis is recommended for definitive diagnosis.

Primary ovarian leiomyoma in a premenarchal adolescent: first reported case

BACKGROUND

Primary ovarian leiomyoma is a rare benign ovarian tumor with only several reported cases in adolescents. Little is known about the origin or natural history of these rare tumors as they have occurred in a variety of presentations and were removed upon presentation without observation.

CASE

A 14-year-old, premenarchal female was found to have a 4 cm mass which grew to 6.5 cm over two years. It appeared sonographically most consistent with a teratoma; however, during surgical resection it was found to be solid, and on pathologic evaluation was identified as an ovarian leiomyoma.

SUMMARY AND CONCLUSION

The growth of this patient's tumor with the onset of puberty supports hormonal responsivity, but its presence prior to menarche suggests an alternate origin, independent of gonadal hormones.

Large ovarian leiomyoma in young woman

Leiomyoma is benign mesenchymal tumor, that frequently occur in uterus but it rarely happens in ovary. Ovarian leiomyomas are seen concomitantly with uterine leiomyoma in about 78% of cases. They often discover incidentally but their most clinical manifestations are abdominal pain and palpable mass. Herein, we reported a large ovarian leiomyoma in a 22-year-old woman with abdominal pain and palpable mass at lower abdominal region. Computed tomography scan revealed large adnexal mass. Microscopic appearance was typical for leiomyoma but because its rarity in ovary the immunohistochemical staining was done. Major differential diagnostic considerations for this tumor in ovary are fibroma/thecoma, sclerosing stromal tumor, and leiomyosarcoma. The immunohistochemical staining with desmin, inhibin, and α-smooth muscle actin are helpful to rule out this differential diagnosis.

Primary ovarian adenomyoma in a woman with endometrial polyp: a case report and review of the literature

BACKGROUND

An adenomyoma presenting outside the uterus is an extremely rare entity and only three cases of primary ovarian adenomyoma have been reported up to date.

CASE REPORT

We report the fourth case of ovarian adenomyoma in a 45-year-old woman with an endometrial polyp. Transvaginal ultrasonography revealed a solitary endometrial polyp with an enlarged left ovary which appeared heterogenous with isoechoic and mildly hyperechoic pattern.

CONCLUSION

Total abdominal hysterectomy and bilateral salpingo-oopherectomy was performed and histologic examination revealed an adenomyoma arising primarily in the ovary.