A case of parasitic fibroid in unscarred abdomen mimicking pedunculated uterine fibroid: a case report.

Introduction and importance: Parasitic leiomyomas are a type of extra-uterine fibroid that develop outside the uterus and thus receive their blood supply from surrounding structures. While most cases are iatrogenic, spontaneous occurrences are rare and often pose diagnostic challenges due to atypical locations. Case presentation: We report the case of a 28-year-old woman, para 2, with no prior abdominal or pelvic surgery, who presented with a 5-year history of intermittent lower abdominal pain. Ultrasound suggested a pedunculated mass arising from the uterine fundus, mimicking an ovarian endometrioma. During laparotomy, a 4.5 × 4.5 cm mass was identified at the mesenteric border near the sigmoid colon. The uterus and adnexa were normal. The mass was completely excised, and histopathology confirmed a benign leiomyoma. The patient recovered uneventfully. Clinical discussion: Spontaneous parasitic leiomyomas are rare and can mimic adnexal or pedunculated uterine masses. Also, the symptoms of the disease may be vague, which makes preoperative diagnosis challenging. Surgical excision is both diagnostic and curative, with excellent outcomes. Conclusion: This case demonstrates a rare spontaneous parasitic leiomyoma arising from the mesentery. Clinicians should consider this entity in the differential diagnosis of extra-uterine masses, even in patients with no history of surgery. Complete excision provides definitive treatment with minimal risk of recurrence.