Broad Ligament Fibroid Mimicking an Ovarian Tumor: A Case Report

Broad ligament leiomyomas are rare extrauterine smooth muscle tumors that can mimic adnexal neoplasms because of their atypical location and degenerative changes. We report the case of a 47-year-old multiparous woman with lower abdominal pain for five to six months, worsening over the preceding eight to 10 days. Ultrasonography demonstrated a large predominantly solid-cystic abdominopelvic mass with minimal vascularity, with neither ovary separately visualized. Magnetic resonance imaging (MRI) revealed a well-defined mass centered in the right broad ligament region, showing a T2-hypointense solid component, cystic degeneration, mild progressive enhancement, and no diffusion restriction; the right ovary was not separately identified, raising suspicion of an ovarian neoplasm. Exploratory laparotomy demonstrated a well-encapsulated right broad ligament mass separate from the uterus, with compression but preservation of the right ovary. The mass was excised with preservation of the uterus, both ovaries, and ureter. Histopathology confirmed a benign leiomyoma with low mitotic activity and absence of coagulative tumor cell necrosis. This case highlights the importance of recognizing characteristic imaging features and anatomical relationships in differentiating broad ligament leiomyomas from ovarian neoplasms.