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Renal leiomyoma is a rare benign mesenchymal tumor. It arises from the smooth muscle cells of the kidney and renal capsule is its most common location. Small tumor may be asymptomatic and usually appears as a well circumscribed peripherally located solid mass. Large tumor may manifest with pain, palpable flank mass or hematuria. Intersecting fascicles of spindle cells showing immunoreactivity to actin or desmin are characteristic histologic features. We present a case of giant renal leiomyoma in a 20-year-old female with chief complaints of abdominal discomfort and lump in her left side of abdomen. AP radiograph showed a large abdominopelvic soft tissue opacity. Contrast-enhanced computed tomography scan revealed a massive well circumscribed exophytic complex solid cystic mass of size 17 cm × 15 cm × 13 cm arising from upper pole of left kidney. The role of percutaneous biopsy is limited in such lesions and surgery is the only therapeutic option. Keywords: Mesenchymal tumor, Renal leiomyoma, Computed tomography (CT)

Leiomyoma is a mesenchymal tumor which arise from any structure or organ containing smooth muscle, but is frequently seen in the female genital tract. Renal leiomyoma is extremely rare benign lesion with low incidence (1:1000), has been reported mostly in adults and very few cases have been described in the pediatric age-group. It is often asymptomatic and can be diagnosed when reaches large sizes. Hereby, we present a case of renal leiomyoma in a smaller size, in the pediatric age group., Highlights • Renal leiomyoma is extremely rare benign lesion in the pediatric age. • Leiomyoma may rarely arise from almost every part of the genitourinary system. • Leiomyoma must be considered in differential diagnosis of benign-looking renal mass. • Definitive diagnosis requires histological examination.

Leiomyoma is an uncommon tumor of the kidney. The authors report a rare case of renal leiomyoma in a 39-year-old male patient who presented with a right flank mass. Laparoscopic nephrectomy was performed. The histopathology and immunohistochemistry confirm the diagnosis of renal leiomyoma. The review of literature in the clinicoradiopathological correlation was illustrated.