# Ovarian leiomyoma: diagnostic challenges and imaging characteristics in a rare case

## TL;DR

This paper presents a rare case of ovarian leiomyoma and discusses the challenges in diagnosing it using imaging and the importance of histopathology for confirmation.

## Contribution

The novelty lies in highlighting the diagnostic challenges and imaging features of a rare ovarian leiomyoma case.

## Key findings

- Ovarian leiomyoma was diagnosed only after histopathological confirmation following imaging.
- Imaging showed a complex adnexal mass with solid and cystic components.
- The case emphasizes the need to consider ovarian leiomyoma in differential diagnosis of adnexal masses.

## Abstract

Ovarian leiomyoma is an extremely rare benign tumour often diagnosed incidentally due to its nonspecific clinical and radiologic features. We present the case of a 48-year-old woman with progressive lower abdominal pain, distention, and genitourinary complaints. Imaging revealed a large complex adnexal mass with both solid and cystic components, seen on ultrasound, CT, and MRI, raising suspicion for a neoplastic process. Despite the use of multiple imaging modalities, definitive diagnosis required histopathological confirmation following surgical resection, which revealed an ovarian leiomyoma with cystic and myxoid degenerative changes. This case underscores the importance of considering ovarian leiomyoma in the differential diagnosis of adnexal masses and highlights the complementary roles of imaging and histopathology in achieving an accurate diagnosis and guiding appropriate management.