Postmenopausal huge ovarian leiomyoma: a rare presentation

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.

Primary Ovarian Leiomyoma Associated with Multiple Uterine Leiomyomas

Ovarian leiomyomas are very rare. We report the case of a primary ovarian leiomyoma accompanied by multiple uterine leiomyomas. A 50-year-old woman was referred to our department for heavy menstruation, and a hot spot in the uterine lumen was observed on positron emission tomography-computed tomography (PET-CT). Cervical and endometrial cytology and tumor marker tests were negative. Pelvic magnetic resonance imaging revealed an endometrial polyp and submucosal leiomyoma in the uterine lumen and a 5-cm right ovarian tumor. Laparoscopic total hysterectomy, right salpingo-oophorectomy, and left salpingectomy were performed for radical treatment. Histopathology showed that ovarian tumors contained interlacing bundles of fusiform cells encircled by normal ovarian tissue. Immunohistochemical staining showed strong and diffuse positive staining for α-smooth muscle actin. We diagnosed the tumor as a primary ovarian leiomyoma because the leiomyoma was localized in the ovary and was larger than the size of uterine leiomyomas. No metastatic lesion was found on PET-CT. There was no tumor recurrence at the 6-month follow-up.