Primary Ovarian Leiomyoma in a 2-year-old Child: Youngest Worldwide and First Report from India with Review of Literature.

Ovarian leiomyomas (OLMs) are rare benign ovarian tumors, representing only 0.5%-1% of all benign ovarian neoplasms and exceptionally uncommon in children. Fewer than 100 cases are reported worldwide, with < 10 in the pediatric and adolescent age group. We report a 2-year-old girl presenting with incidental abdominal fullness. Imaging revealed a right adnexal mass, and intraoperatively, the tumor was found to completely replace the right ovary. Right oophorectomy with omentectomy and peritoneal washings was performed. Histopathology showed spindle-shaped smooth muscle cells with minimal atypia, and immunohistochemistry confirmed OLM with positivity for smooth muscle actin and desmin. The child had an uneventful recovery and remains well at 9 months of follow-up. This represents the youngest case worldwide and the first reported from India.