Primary leiomyosarcoma of the omentum presenting as an ovarian carcinoma, case report and review of the literature

•Primary leiomyosarcoma of the omentum can mimic the presentation of an ovarian carcinoma.•The diagnosis is based mostly on the appearance on Computerized Tomography scan and angiography.•Complete surgical resection of this tumor can lead to long term survival.

Primary omental leiomyosarcoma is a rare tumor. We report a case of successfully resected omental leiomyosarcoma whose presentation mimicked ovarian carcinoma. Symptoms of abdominal distension and discomfort that lasted 8 months followed by pain lead to a diagnosis of a large mass in the abdomen. Physical examination revealed a large, over 20 cm tumor, suspected to be of ovarian origin. A small amount of ascites was found on Computerized Tomography (CT) and ultrasound (US) scans. Total abdominal hysterectomy with bilateral salpingo-oophorectomy, omentectomy and tumor debulking procedure was planned. Laparotomy revealed normal uterus ovaries and tubes with a leiomyosarcoma of the omentum which was completely resected successfully. Only 26 cases of primary leiomyosarcoma of the omentum were previously described in the literature. A review of the literature is also presented.