Introduction. Leiomyoma is a mesenchymal benign tumor that seldom manifests
in the kidney. Typically, these tumors are small, asymptomatic, and often
detected accidentally. Differentiating leiomyomas radiologically from other
renal neoplasms, particularly renal cell carcinomas, poses a considerable
challenge before surgical intervention. Moreover, the conclusive diagnosis
of leiomyomas can only be established through histopathological and
immunohistochemical evaluation following surgical intervention. Case Report.
We present a case of a 44-year-old woman who was diagnosed with right kidney
leiomyoma accidentally during a computed tomography examination following
exploratory curettage by a gynecologist. An enhanced computed tomography
scan revealed a 10 mm tumor located on the upper pole of the right kidney,
extending beyond its boundaries. The imaging differential diagnosis was
renal cell carcinoma of the right kidney. A laparoscopic partial nephrectomy
was performed. Macroscopically, the tumor appeared subcapsular,
well-defined, with a firm consistency and a tan-white whorled cut surface.
The histological characteristics and the supporting immunohistochemical
profile confirmed the diagnosis of renal leiomyoma. The postoperative course
was uneventful, and the patient was discharged on the 3rd postoperative day.
Conclusion. Leiomyomas are rare kidney tumors. A conclusive diagnosis is
established through histopathological findings. The pre-operative
differentiation of leiomyomas radiologically from other renal neoplasms,
particularly renal cell carcinomas, poses a considerable challenge in
radiological assessment.