Radiating thigh pain from a torsed pedunculated round ligament fibroid

Round ligament fibroids are rare, benign tumours that can arise from any part of the round ligament, either extra-abdominal or intra-abdominal, and may present as vulvar, inguinal or adnexal masses. Most often found in premenopausal women, these lesions are generally without symptoms and are discovered by chance. However, they can lead to pelvic pain, particularly if they undergo torsion or increase in size. While imaging techniques such as ultrasonography, CT and MRI are valuable for initial assessment, laparoscopy remains the definitive method for both diagnosing and managing round ligament fibroids. Laparoscopy offers multiple benefits, such as enabling tissue biopsies, shortening hospital stays and promoting quicker recovery. However, owing to their stalk-like structure, pedunculated round ligament fibroids are frequently mistaken for ovarian cysts or inguinal hernias. We present the case of a middle-aged woman who successfully underwent laparoscopic surgery for a torsed right round ligament fibroid.