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Cotyledonoid dissecting leiomyoma (CDL) may create a diagnostic challenge. A 47-year-old woman underwent laparotomy for a large pelvic mass associated to vaginal bleeding. During operation, a bulky deep red mass protruding from the uterus and projecting into the pelvic cavity was discovered. Allowing to sarcoma- like appearance, a total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed with removal of the pelvic tumor extension. The diagnosis of cotyledonoid dissecting leiomyoma of the uterus associated with endosalpingiosis was performed. To the best of our knowledge, this association has never been encountered in the English literature.

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A 43-year-old woman, presented with a tender mobile lump in the lower inner quadrant of the left breast. On examination, there was no local lymphadenopathy. Mammography showed a 20 mm, dense, well circumscribed lesion suggesting a fibroadenoma (Fig. 1). The lump was excised and no axillary dissection was made.Grossly, the specimen excised measured 35 · 25 · 15 mm, it was occupied by a well circumscribed, yellow, firm mass. No areas of necrosis were identified.At histological examination (Fig. 2), the tumor had well-defined margins. It was composed of an adipocytic proliferation presenting a variation in cell size with focal nuclear atypia and hyperchromasia. Scattered atypical, hyperchromatic stromal cells were noted in a fibrillary, collageneous stroma. Occasionally, a varying number of monovacuolated or multivacuolated lipoblasts were recognized. An arborizing Figure 2. Associated osteoclast-like giant cells (arrows).Figure 3. Tumor cells were synaptophysin positive whereas the osteoclast-link giant cells were negative (arrow).

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