Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 8 5 2024 04 20 228 229 Mehri Sakhdari Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Asieh Maleki Supporting the Family and the Youth of Population Research Core, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran 2023 11 14 2024 01 27 Primary ovarian leiomyoma is a rare benign ovarian tumor that occurs in women between the ages of 20 and 65. This tumor is usually diagnosed incidentally through pelvic examination or histopathological study after surgery. A definitive preoperative diagnosis is difficult due to the lack of pathognomonic signs or specific imaging features. Therefore, histopathological examination and immunohistochemical analysis are considered necessary. The authors report a case of a 49-year-old woman with ovarian leiomyoma who had a history of heavy vaginal bleeding. She underwent laparotomy with a preoperative diagnosis of uterine fibroids. https://crcp.tums.ac.ir/index.php/crcp/article/view/894