A Subserosal Fibroid With Myxoid Degeneration: A Challenging Pelvic Mass.

BACKGROUND: Leiomyomas are common gynecological masses. However, atypical variants, such as those with myxoid degeneration, can mimic malignancies. This, in turn, might result in diagnostic challenges. CASE PRESENTATION: A 29-year-old female presented with chronic pelvic pain and backache. Imaging revealed a 10-cm adnexal mass with features suspicious of endometrioma or malignancy. Laparoscopic resection was performed. Histopathology confirmed a leiomyoma with myxoid degeneration. DISCUSSION: Myxoid degeneration, a rare type of leiomyoma degeneration, can alter typical findings on imaging. It can also lead to uncertainties when it comes to diagnosis. This case highlights the importance of correlating imaging with histopathology to avoid unnecessary or radical surgeries. CONCLUSION: Atypical leiomyomas should be considered in the differential diagnosis of pelvic masses, despite their rarity. Accurate diagnosis and management can prevent overtreatment. It also ensures optimal patient outcomes.