Preoperative sonographic assessment of a leiomyoma of the round ligament

We report a case of leiomyoma of the round ligament in a 59-year-old woman, with suspicion of ovarian cancer during gynaecological routine examination. Transvaginal ultrasound showed a heterogeneous solid pelvic mass in the left adnexal area but during the evaluation of its anatomical relation, both ovaries appeared to be regular and the neoformation was separated from the uterus. Surgical and pathological examination revealed well-defined solid mass arising from the left round ligament of the uterus identified as leiomyoma with myxoid degeneration. Leiomyomas of the Round Ligament of the uterus are very rare tumors and they may arise as inguinal, pelvic or vulvar masses miming an inguinal hernia, a lymphadenopathy or a solid adnexal mass. The preoperative sonographic assessment is essential to perform a correct differential diagnosis and provide a right management of the case.