Abstract:Desmoid is a rare tumor caused by abnormal proliferation of fibroblastic cells. The tumor may arise from fascia or/and aponeurosis of muscle. They may reach huge sizes often causing a diagnostic dilemma. Here, we present a rare case of desmoid tumor mimicking broad ligament fibroid, in a 23 year old woman without any known risk factors. Initial investigations attributed to wrong diagnosis of uterine leiomyoma whereas further investigations and surgical exploration revealed it to be a desmoid tumor. The tumor was removed completely with clear margins, and the decision regarding adjuvant chemo/radiotherapy was kept on hold depending upon the recovery and follow up visits. The patient has remained asymptomatic till date. In the case reported here, the patient's only presenting complaint was a painless abdominal mass. This added to the initial difficulty in diagnosis. So, thorough clinical examination keeping in view all the possible presentations of an abdominal mass in women is equally important in all such cases. Residual tumor and recurrence after initial resection may require adjuvant treatment with chemotherapy and/or radiation in addition to repeat surgery. Close follow up of the patient is the key to complete recovery.

Background Leiomyoma is a benign fibromuscular neoplasm originating from smooth muscle cells. Paraurethral leiomyoma is an extremely rare, benign, hormone-dependent growth from the mesenchymal cells in paraurethral space of female urethra. They usually appear in the reproductive age group women, mean age of presentation being approximately 41 years. Case presentation A 48-year-old woman presented with palpable mass at vagina and weak urinary stream. She underwent clinical examination and CT scan and MRI imaging followed by transvaginal excision of the mass. Histopathological examination confirmed paraurethral leiomyoma. Conclusions Paraurethral leiomyoma owing to its rare incidence poses a diagnostic dilemma for the gynecologists. Radiological imaging techniques help in diagnosis. Surgical excision via vaginal route is the treatment of choice. Diagnosis is confirmed by histopathology.