Cotyledonoid dissecting leiomyoma as a possible cause of chronic lower back pain

Onu, David O; Fiorentino, Lisa; Bunting, Michael W

doi:10.1136/bcr-2013-201350

Cited by 6 publications

(4 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…At present, ~43 cases of CDL have been reported in the English literature (3). An accurate diagnosis of CDL is challenging prior to surgery, as the distinctive grapelike (4) gross appearance of an exophytic mass resembles placental tissue and is almost always misdiagnosed clinically as an ovarian tumor or uterine sarcoma (5)(6)(7)(8). The majority of patients with CDL are diagnosed during an exploratory laparotomy (1,(9)(10)(11), and a frozen section is recommended to be used for the diagnosis of CDL (7,9).…”

Section: Introductionmentioning

confidence: 99%

Cotyledonoid dissecting leiomyoma of the uterus: A report of four cases and a review of the literature

Yang

et al. 2016

Oncology Letters

View full text Add to dashboard Cite

Abstract. Cotyledonoid dissecting leiomyoma (CDL), also termed Sternberg tumor, is a variant of uterine leiomyoma that is rarely diagnosed by clinical evaluation. At present, ~43 cases of CDL have been reported in the literature written in the English language. Due to the distinctive grapelike gross appearance of an exophytic mass resembles placental tissue, CDL is often misdiagnosed clinically as an ovarian tumor or uterine sarcoma. Therefore, an awareness of the features of the disease is important to prevent misdiagnosis and overtreatment. The present study reports 4 cases of CDL of the uterus that were treated at the Second Hospital of Jilin University between January 2009 and December 2011. All 4 patients in the current study presented with a palpable asymptomatic pelvic mass, which was detected during physical examinations, and cancer antigen 125 tumor marker levels that were within the normal range. The exploratory laparotomy of the 4 patients revealed lobulated tumors with a grapelike appearance extending from the lateral uterine wall into the ligament or the adjacent tissues. The frozen section and postoperative pathology were diagnosed as CDL. A total abdominal hysterectomy was performed in the first case of a 55-year-old woman that had been in menopause for 7 years. The patient was well and showed no evidence of disease subsequent to 48 months of follow-up. A total abdominal hysterectomy and right salpingo-oophorectomy were performed in the second case of a 43-year-old woman, who was well and showed no evidence of disease subsequent to 26 months of follow-up. A subtotal abdominal hysterectomy and bilateral salpingectomy were performed in the third case of a 37-year-old woman, who was well and showed no evidence of disease subsequent to 27 months of follow-up. A total abdominal hysterectomy and right-salpingectomy were performed with the removal of a retroperitoneal fibroid extension in the fourth case of a 48-year-old woman, who was well and showed no evidence of disease subsequent to 32 months of follow-up.

show abstract

Section: Introductionmentioning

confidence: 99%

Cotyledonoid dissecting leiomyoma of the uterus: A report of four cases and a review of the literature

Yang

et al. 2016

Oncology Letters

View full text Add to dashboard Cite

show abstract

“…Successful hormonal therapy with ulipristal acetate or gonadotropin‐releasing hormone analogues was described before surgery to achieve a reduction in the mass volume and symptoms, 10,20 but no woman was treated this way in our case series. On the other hand, when malignancy is suspected, the surgical approach usually relies on radicality with hysterectomy and monolateral or bilateral salpingectomy/salpingo‐oophorectomy or can be even more extensive 21 . In only 1 case in our series (case 6) were a class B radical hysterectomy, right salpingo‐oophorectomy, and omentectomy performed after the extemporaneous examination for the suspicion of an infiltrative process and a malignant nature of the lesion.…”

Section: Resultsmentioning

confidence: 95%

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

Buonomo

Bussolaro

Giorda

et al. 2020

J of Ultrasound Medicine

View full text Add to dashboard Cite

Cotyledonoid leiomyoma of the uterus is a rare variant of benign uterine leiomyoma. It has a favorable attitude, despite some ultrasound presentations. A bulky uterus with a heterogeneous mass with irregular margins, high vascularity, and infiltration of the myometrium can induce the suspicion of a malignant mesenchymal tumor and lead to a radical surgical treatment. If present, some imaging features may suggest this rare type of leiomyoma, thus avoiding extensive surgery, especially in young nulliparous women. We report 13 cases of cotyledonoid leiomyoma with clinical characteristics, imaging features, and a literature review.

show abstract

“…Documented female specific intrapelvic sciatic lesions include the following: endometriosis, pregnancy/labor related complications, adenomyosis, retroverted uteri, and fibroid variants. 1,[11][12][13] Fibroids (leiomyomas, myomas, fibromyomas), which are well-circumscribed nonencapsulated benign tumors, are the most common benign mass of uterine origin. 14 In women older than 35 yrs, they are estimated to have at least a 20%-25% prevalence.…”

Section: Discussionmentioning

confidence: 99%

“…When accounting for additional female intrapelvic structures adjacent to the sciatic nerve’s origins before exiting the pelvis, there are ample additional opportunities for intrapelvic sciatic nerve lesions in women. Documented female specific intrapelvic sciatic lesions include the following: endometriosis, pregnancy/labor related complications, adenomyosis, retroverted uteri, and fibroid variants 1,11–13 …”

Section: Discussionmentioning

confidence: 99%

Atypical Cause for Back Pain and Sciatica in a 35-year-old Female with Fibromyalgia

Naber

Netzloff

Bakshi

2023

Am J Phys Med Rehabil

View full text Add to dashboard Cite

Spinal and extrapelvic lesions causing sciatic symptoms are well recognized in clinical research and practice. 1–5 We present a 35-yr-old woman with a history of axial back pain and fibromyalgia who presented with episodes of radicular type pain down her legs and associated bilateral tingling in her feet. Medicinal and therapeutic interventions for traditional sciatica etiologies failed to provide relief. Lumbar magnetic resonance imaging showed mild multilevel degenerative changes and partially visualized fibroids, but no other significant spinal pathology was appreciated. Subsequent pelvic magnetic resonance imaging revealed an enlarged retroverted uterus with multiple fibroid lesions. The patient elected for laparoscopic myomectomy, which improved her likelihood of fertility while drastically alleviating her axial spine and lower extremity symptomology. This case reinforces the importance of keeping a broad differential that includes intrapelvic etiologies when traditional workup and treatment for sciatic neuropathy fails. To our knowledge, this is the first reported case of sciatic neuropathy secondary to uterine fibroids treated with the intent of both fertility improvement and pain relief.

show abstract

Cotyledonoid dissecting leiomyoma as a possible cause of chronic lower back pain

Cited by 6 publications

References 9 publications

Cotyledonoid dissecting leiomyoma of the uterus: A report of four cases and a review of the literature

Cotyledonoid dissecting leiomyoma of the uterus: A report of four cases and a review of the literature

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

Atypical Cause for Back Pain and Sciatica in a 35-year-old Female with Fibromyalgia

Contact Info

Product

Resources

About