Arch Gynecol Obstet (2007) 275:507–510 DOI 10.1007/s00404-006-0291-3 123 CASE REPORT Unilateral primary ovarian leiomyoma in adolescent: a case report Mehmet Güney · Mesut Özsoy · Baha Oral · Tamer Mungan · Nilgün Kapucuoflu Received: 18 September 2006 / Accepted: 2 November 2006 / Published online: 1 December 2006  Springer-Verlag 2006 Abstract Background Primary ovarian leiomyoma is a rare, usually small and incidentally detected neoplasm, clini- cally indistinguishable from subserous leiomyomas and ovarian Wbromas, until histopathological conWrmation. Case report We report a rare case of unilateral, ovar- ian leiomyoma that was not associated with uterine tumor in a 17-year-old woman. Trans abdominal ultra- sonography and magnetic resonance imaging (MRI) revealed a pelvic mass (15 cm £ 12 cm). Conclusion At laparotomy, unilateral salpingo-ooph- orectomy was performed and histologic examination revealed a leiomyoma arising primarily in the ovary. Keywords Adolescent · Immunohistochemistry · Magnetic resonance image · Ovarian leiomyoma · Ovarian tumor Introduction Primary ovarian leiomyoma is a rare, unilateral, soli- tary and usually asymptomatic tumor [1, 2]. The tumor usually appears in pre-menopausal women, and is fre- quently associated with uterine leimyomas [3]. Most patients are asymptomatic, and the tumors are usually not detected on pelvic examination. They are fre- quently diagnosed as subserous leiomyomas or Wbro- mas until a histopathological conWrmation and it could be confused with other spindle cell tumors such as the- coma/Wbroma to which, they have gross and histologic similarities. We report a rare case of unilateral primary ovarian leiomyoma that was unusually large and pre- sented in a 17-year-old adolescent woman. Case presentation A 17-year-old unmarried, virgin female patient was referred to our University Hospital (Isparta, Turkey), with a history of a sonographically detected lower abdominal mass at a local clinic. The mass was Wrst detected 1 week before her admission. Her past history was not remarkable. A vaginal examination was not performed since she was a virgin. Abdominal examina- tion revealed a Wrm, large, mobile, well-deWned soft tis- sue mass, extended 2 cm below the level of umbilicus. Other physical examination Wndings were normal and laboratory data, including the various tumor markers were within normal limits. On transabdominal ultraso- nography, the mass showed homogeneously isoechoic patterns and measured approximately 15 £ 14 £ 12 cm in all diameters. Pelvic MRI showed a 15 £ 12 cm peritoneal solid tumor on the left of the uterus that exhibited low- intensity signals on both T1- and T2-weighted images. MRI Wnding was strongly suggestive of an ovarian Wbroma or pedunculated subserous leiomyoma of the M. Güney · M. Özsoy · B. Oral · T. Mungan Department of Obstetrics and Gynecology, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey N. Kapucuoflu Department of Pathology, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey M. Güney (&) Modernevler Mahallesi Ãstanbul, Caddesi Karaday Apt Kat:1 Daire:2, Isparta 32100, Turkey e-mail: mguney@med.sdu.edu.tr