Epithelioid cotyledonoid leiomyoma of uterus

Abstract

A 42-year-old para 2 women underwent laparotomy with a preoperative diagnosis of leiomyoma uterus and ovarian endometrioma. At laparotomy, uterus was 12-week size and bilateral tubes and ovaries were normal. There was a large friable reddish-brown mass dissecting the leaves of broad ligament with extension into pelvic cavity and retroperitoneal spaces. Total abdominal hysterectomy with bilateral salpingo-oophorectomy with resection of tumour was performed as there was concern about the possibility of malignancy. Histopathological examination revealed a cotyledonoid leiomyoma epithelioid variant. These tumours, though benign, raise the possibility of malignancy at the time of surgery due to their bizarre and sarcoma-like appearance. It is important for the pathologist and gynaecologist to be aware of this rare variant of leiomyoma to avoid an overtreatment

Cotyledonoid Leiomyoma Clinical Characteristics, Imaging Features, and Review of the Literature

“…Moderate vascularization (CS 3) is typical of the dissecting form. Sometimes, some fluid parts in the inner portion are present because of colliquative necrosis in its core 12,13 . The shadowing was not described for any of the lesions in the literature.…”

Cotyledonoid dissecting leiomyoma with adipocytic differentiation: A case report

“…While this case was classified as a recurrence, incomplete resection with regrowth of persistent disease should always be taken into consideration. Literature review indicates that 24 patients were treated with total hysterectomy accompanied by unilateral or bilateral salpingo-oophorectomy, and 13 cases received a hysterectomy with ovarian preservation, all without evidence of recurrence ( Smith et al, 2012 , Chawla et al, 2014 , Geynisman et al, 2014 ). Eight patients were treated with tumor resection alone with one documented recurrence ( Smith et al, 2012 , Roth et al, 2013 , Tanaka et al, 2013 ).…”

Cotyledonoid dissecting leiomyoma with intravascular growth pattern and intra-tumoural endometrial glands and stroma: A case report

“…Over 30 cases of this tumour have been reported up to this date in the published literature, one of which had described the presence of adenomyosis within the tumour. [3] Uterine cotyledonoid dissecting leiomyomas with intravascular luminal growth, [4] epithelioid variant, [5] hydropic variant [6] and CDL with adipocytic differentiation [7] have also been described. The present case is the second described case in the published literature of a CDL in which non-neoplastic endometrial glands with endometrial stromal cells are present together with an intravascular luminal growth component.…”