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Ovary : Leiomyoma

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Ovarian leiomyomas are rare tumors. They occur over a wide age range. Most arise in premenopausal women (mean age at presentation 43 years). Most cases are discovered incidentally. One-third of patients have non-specific symptoms such as abdominal pain, swelling (due to ascites), or discomfort. Rare cases undergo torsion and present with acute abdomen.

Grossly, they are solitary, solid, unilateral, and well-circumscribed but not encapsulated. The cut surface is tan, brown, or white with a whorled or multinodular appearance. Foci of myxoid change, pseudocystic areas, hemorrhage, calcification, and necrosis may be present.

The histogenesis of ovarian leiomyomas is uncertain. Possible sites include hilar smooth muscle, ovarian blood vessels, or smooth muscle metaplasia of ovarian stroma. Rare cases may be associated with Meigs' syndrome, peritoneal leiomyomatosis, and intravenous leiomyomatosis.

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