Rare Presentation of Parasitic Leiomyomata in the Fallopian Tube and Ovarian Ligament: Clinical, histopathologic, and imaging insights.

Fallopian tube leiomyomas are exceptionally rare parasitic tumours, usually identified incidentally during laparoscopic or open surgery. This report describes a 30-year-old woman who presented in 2025 to Al Emadi Hospital in Doha, Qatar with chronic pelvic pain and acute exacerbations. The diagnosis of fallopian tube leiomyoma was made through preoperative clinical and imaging findings, intraoperative observations, and histopathological analysis. In addition, this case includes the first documented instance of a parasitic leiomyoma of the ovarian ligament, lending support to the theory of metaplasia in its pathogenesis. Parasitic leiomyomas should be considered whenever a leiomyoma is detected outside the myometrium on imaging studies. The rare occurrence of fallopian tube leiomyomas warrants inclusion in the differential diagnosis of acute exacerbations of chronic pelvic pain in patients presenting with solid adnexal masses, particularly when such masses are palpable vaginally or visualised as distinct from the uterus. The absence of epidemiological data on parasitic leiomyomas of the fallopian tube and ovarian ligament underscores the need for further case reports and series to raise physician awareness of these extremely rare lesions.