ABSTRACT
Endometrial stromal nodules (ESN) are benign tumours of mesenchymal origin with features reminiscent of proliferative phase endometrial stroma. Diagnosis of ESNs can be established only by light microscopy and no preoperative diagnostic methods are available. Although ESNs are benign and rare, distinguishing it from other types of invasive stromal tumours is of utmost importance since prognosis and management change considerably with the diagnosis. This was a rare case report of endometrial stromal nodule in a nulliparous woman, 30 years old who presented with complaint of menorrhagia and primary infertility and had a preoperative diagnosis of large leiomyoma with cystic degeneration. She underwent a fertility preserving conservative surgery i.e. myomectomy via abdominal route, histopathology reports of which revealed endometrial stromal nodule that changed the final diagnosis and follow up regime of the patient.