Clinical characteristics and laparoscopic management experience of primary ovarian leiomyoma

Primary leiomyoma is one of the rarest benign ovarian tumors. Since the first case was identified, less than 100 cases have been reported worldwide. This study aimed to analyze the clinical characteristics and discuss the proper management of this tumor. A review of the patients' medical records was undertaken from January 2015 to December 2023. A total of 21 cases of primary ovarian leiomyoma and 5 cases of inherent ligament leiomyoma were identified. The mean age was 45.6 years (17-67 years). The tumor size ranged from 1.2 to 7.0 cm (mean, 3.7 cm) by ultrasound. Eighteen (69.2%) patients complained of an asymptomatic pelvic mass. None of them was successfully diagnosed before the surgery. Twelve patients underwent laparoscopic salpingo-oophorectomy or oophorectomy with a mean diameter of 2.9 cm and an average age of 54.2 years. Meanwhile, 12 patients underwent laparoscopic tumorectomy with a mean diameter of 3.0 cm and an average age of 39.3 years. Besides, two patients underwent laparotomic tumorectomy. After a mean follow-up of 35.7 months, patients were alive with no disease recurrence. In conclusion, tumorectomy is preferred for patients with conception requirement or at reproductive age. Laparoscopic surgery is considered as an effective and safe approach.