De novo growth of leiomyoma from rectus sheath: A rare presentation

Abdominal wall leiomyomas are a rare finding and are thought to follow seeding following surgical resection of uterine fibroids. There is paucity of findings of isolated abdominal wall fibroids in the literature without previous surgeries for myomectomies or presence of uterine fibroids. We present a case of a 34-year-old parous lady with no previous abdominal or gynecological surgeries presenting with a periumbilical lump of 1 year duration. The operative findings revealed a large mass in the parietal layers of the anterior abdominal wall attached to the right rectus sheath with no intra-abdominal attachments. Histopathology revealed features suggestive of a leiomyoma. We conclude that rectus sheath leiomyomas do exist and can present in a woman with no previous surgeries and hence should be borne in mind while diagnosing an anterior abdominal wall mass.