Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 9 5 2025 04 26 203 207 Elham Zare Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Ali Beheshti Namdar Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. 2024 12 01 2025 02 02 Leiomyomas are most commonly encountered in the genitourinary and gastrointestinal systems, with primary hepatic leiomyomas (PHL) being a rare occurrence. We present the case of a 62-year-old man with an incidentally discovered voluminous lesion in the left lobe of the liver, initially suspected to be a hemangioma. The patient was referred for further evaluation, during which advanced imaging modalities were utilized for accurate diagnosis, and tissue biopsies were obtained. A definitive diagnosis of PHL was established through immunohistochemistry based on pathological findings.   https://crcp.tums.ac.ir/index.php/crcp/article/view/1003 https://crcp.tums.ac.ir/index.php/crcp/article/download/1003/685