# Unexpected Adnexal Torsion and Hemoperitoneum Caused by Spontaneous Ovarian Parasitic Leiomyoma: A Case Report

## TL;DR

A rare case of a spontaneous ovarian parasitic leiomyoma causing severe pelvic pain and internal bleeding is reported, highlighting its importance in diagnosis.

## Contribution

This case provides new insight into the rare etiology of spontaneous ovarian parasitic leiomyomas.

## Key findings

- A 37-year-old woman presented with acute pelvic pain due to adnexal torsion from a parasitic leiomyoma.
- Histopathology confirmed a benign leiomyoma within the ovarian tissue.
- The case emphasizes the need to consider parasitic myomas in differential diagnoses of acute pelvic pain.

## Abstract

Parasitic myomas (PMs) are rare uterine leiomyomas that exist independently of the uterus. They can result from tissue fragments left behind during laparoscopic uterine procedures or, less commonly, develop spontaneously from pedunculated subserosal leiomyomas that detach and revascularize on extrauterine structures. We present a case of a 37-year-old woman with a history of pedunculated subserosal leiomyoma who presented in the emergency department with acute pelvic pain. Imaging revealed a large pelvic mass separated from the uterus and significant hemoperitoneum. Emergency laparotomy was performed, identifying a large left adnexal mass causing adnexal torsion, with partial pedicle rupture as the bleeding source. Histopathology confirmed a benign leiomyoma in the ovarian parenchyma. This case underscores the importance of considering PMs in the differential diagnosis of acute pelvic pain and provides more insight about the etiology of spontaneous PMs, which are rare entities.