Precoccygeal leiomyoma: A rare cause of pelvic and anal pain

Precoccygeal tumors are an uncommon group of heterogenous lesions ranging from benign simple cysts to complex malignant masses. Their nonspecific clinical presentations often make diagnosis difficult. Cross-sectional imaging, including computed tomography (CT) and magnetic resonance imaging (MRI), plays a critical role in their detection and characterization. Magnetic resonance imaging is considered the gold standard owing to its superior soft tissue resolution and detailed anatomical evaluation. Surgical excision remains the treatment of choice. Prognosis depends on the tumor's nature and completeness of resection. Herein, we present the case of a precoccygeal leiomyoma in a premenopausal female patient with episodic, deep-seated pelvic and anal pain that worsened during ovulation.