International Journal of Research and Reports in Gynaecology

Ovarian leiomyoma is a rare ovarian mesenchymal tumor found in young adult to menopausal women. These tumors are suggested to arise from smooth muscle cells of walls of blood vessels in ovary. Pre-operative diagnosis is extremely difficult and is most often misdiagnosed as subserosal fibroid or solid ovarian tumor. Presenting symptoms are also vague. This tumor is mostly diagnosed in frozen section examination during surgery or postoperative histopathological diagnosis. Immunohistochemistry (IHC) is suggested to confirm its diagnosis as it can be confused with many differential diagnoses. In this case also, IHC was used for confirmation which showed Smooth muscle actin (SMA) and H- caldesmon positivity. Though ovariotomy can be done in late adulthood, peri-operative diagnosis of this unusual entity becomes very important in young adults for providing fertility preserving options in management and sparing the ovaries.