A Rare Case of Leiomyoma-Associated Cutaneous Sinus Tract Secondary to an Infected Uterine Leiomyoma Without Prior Myomectomy.

Background: Leiomyoma-associated cutaneous sinus tracts are exceptionally rare and typically associated with prior uterine surgeries, such as cesarean section or myomectomy. Fistula formation from an infected uterine leiomyoma involving the uterine parenchyma, without prior myomectomy, represents an uncommon clinical presentation. Case: A 22-year-old woman with a history of cesarean section 5 months prior presented with purulent discharge from an abdominal mass. Imaging revealed a large uterine mass containing gas, with a fistulous tract extending to the abdominal skin. Laparotomy confirmed a fistulous tract extending from the abdominal skin to an infected leiomyoma within the uterine fundal parenchyma, without demonstrable communication with the endometrial cavity. Surgical intervention consisted of fistula closure, myomectomy, and drainage. Histopathological examination confirmed the presence of a uterine leiomyoma with chronic suppurative inflammation, consistent with an infected myoma. The patient remained asymptomatic for 15 months following surgery. Conclusion: This case highlights a rare variant of leiomyoma-associated cutaneous sinus tract arising from an infected uterine leiomyoma involving the uterine parenchyma. Careful diagnostic evaluation and tailored surgical management resulted in complete recovery and a favorable long-term outcome.