Leiomyoma of the greater omentum presenting with massive ascites

INTRODUCTION: Primary tumours of the omentum are quite uncommon, although it is a common site for for secondaries.PRESENTATION OF CASE: We report a case of leiomyoma of the greater omentum in a 31-year-old nulliparous woman who presented with a 2-year history of progressive abdominal distension with examination findings of massive ascites and a mobile ill-defined centrally located intra-abdominal mass. The preoperative diagnosis was equivocal. At surgery a pedunculated greater omental mass, which was histologically reported as a leiomyoma, was seen. She had an uneventful post-operative recovery. She has been followed up for twelve months with no evidence of recurrence or residual disease.DISCUSSION: Extra-uterine leiomyoma is rare. It is even rarer for it to originate from the omentum. Pre-operative diagnosis is challenging. To the best of our knowledge this is the first reported case of leiomyoma of the omentum in Nigeria.CONCLUSION: The uncommon association of ascites with this tumour deserves further scrutiny. The patient is still being followed-up.