Among all benign primary ovarian smooth muscle tumors, ovarian leiomyoma, is uncommon, accounting for 0.5-1% of all tumors. Most of these tumors are unilateral, small in size, and generally occur in premenopausal women. This paper presents a case report of primary ovarian leiomyoma, which is a rare entity, in a postmenopausal female with complaints of abdominal pain. The left ovarian mass was histopathologically and immunohistochemically diagnosed as ovarian leiomyoma. Unlike smooth muscle tumors of uterine origin, there are no definite histological criteria to categorize smooth muscle tumors of ovary. This is an additional case of ovarian leiomyoma with brief review of literature, especially highlighting differential diagnosis of ovarian spindle cell lesions.
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