A Rare Case of Isolated Primary Leiomyoma Discovered Within an Ovarian Endometrioma: A Case Report

A woman in her 30s presented to the emergency department with a one-day history of acute lower abdominal pain, which was not related to her menstruation and not associated with any bowel or urinary tract symptoms. Examination findings revealed a palpable pelvic mass extending up to the level of the umbilicus with generalized tenderness and abdominal guarding over the suprapubic and left lower abdominal regions. Transvaginal ultrasonography findings revealed a large 13.6-cm lobulated cystic mass with low-level sonographic echogenicity in the left adnexal region containing a 6-cm solid area with tiny cystic spaces. She underwent an emergency laparotomy for left ovarian cystectomy, with peritoneal washings aspirated for cytological evaluation. Histological diagnosis of the ovarian cyst revealed an isolated benign ovarian leiomyoma within an endometriotic cyst.