Background: It is very uncommon to find leiomyomas in extraperitoneal sites and only three cases of abdominal wall leiomyomas have been reported in literature so far. Direct seeding of the site by a prior abdominal surgery on the uterus and a conducive metabolic environment have been recognized as etiologic factors in these cases. Case: We report the first case of a large abdominal wall leiomyoma developing in a vaginally hysterectomized postmenopausal woman with no known predisposing factor. The possible etiogenesis and surgical implication of tumors in this location are discussed. Conclusion: Leiomyomas of the abdominal wall may mimic gynecologic tumors in presentation and should be considered in the differential diagnoses. (J GYNECOL SURG 31:373)
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