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We describe a 42-year-old woman with a solid breast mass of smooth muscle cell origin. Breast leiomyoma is an extremely rare benign tumour, with only 11 cases reported thus far. Various explanations have been offered with regard to its origin, such as hamartoma, embryonal migration from the nipple tissue, multipotent mesenchymal cells or the presence of myoepithelial cells originating from the breast...