Cotyledonoid Dissecting Leiomyoma of the Uterus: An Unexpected Diagnosis After Delivery

Rocha, Ana Carolina; Oliveira, Mariline; Luís, Pedro; NOGUEIRA, M.

doi:10.20344/amp.8707

Cited by 3 publications

(1 citation statement)

References 8 publications

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“…Endosalpingiosis has also been associated with uterine CDL as an incidental finding on macroscopic and microscopic examinations (unique case from Driss et al 29 ). Rocha et al 30 also described a uterine CDL and a synchronous ovarian CDL for the first time. This ovarian lesion appeared as a small gray mass other than the CDL of the uterus, and it was accidentally discovered during surgery and removed by a tumorectomy.…”

Section: Resultsmentioning

confidence: 99%

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

Buonomo

Bussolaro

Giorda

et al. 2020

J of Ultrasound Medicine

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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.

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Section: Resultsmentioning

confidence: 99%

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

Buonomo

Bussolaro

Giorda

et al. 2020

J of Ultrasound Medicine

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Cotyledonoid dissecting leiomyoma of the uterus: a case report and review of the literature

Chahkandi,

Ataei,

Bina

et al. 2023

J Med Case Reports

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Background Cotyledonoid dissecting leiomyoma, also named Sternberg tumor, is a rare variant of uterine leiomyoma. The tumor is benign, but the appearance and growth pattern are unusual and alarming. In this article, we report a case of cotyledonoid dissecting leiomyoma in a 55-year-old woman as well as review relevant literature. Case presentation We report a case of cotyledonoid dissecting leiomyoma in a 55-year-old Iranian woman who presented with vaginal bleeding 4 months after menopause. Ultrasound showed two heterogeneous hypoechoic masses on the uterine fundus. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed for the patient. Macroscopically, a large heterogeneous intramural mass (140 mm × 120 mm × 120 mm) with a grape-like exophytic mass on the fundus was observed. Her health status was good after surgery, and the patient was discharged from the hospital after 2 days. In a 1-year follow-up period, no recurrence or any other related complications were found. Conclusion It is important to recognize this rare variant of leiomyoma to prevent aggressive and inappropriate overdiagnosis and overtreatment. It is suggested to try to use frozen sections for better diagnosis and to preserve fertility in young women suffering from this lesion.

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The Management of the Cotyledonoid Leiomyoma of the Uterus: A Narrative Review of the Literature

Buonomo

Bussolaro

Fiorillo

et al. 2021

IJERPH

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Cotyledonoid leiomyoma is an unusual uterine myoma due to some ultrasound features that mimic a malignant lesion facilitating the choice of radical surgery. This study aims to summarize the ultrasound and the magnetic resonance imaging aspects of this atypical lesion, and also discuss surgical treatment and pathological exam. It included all English case reports or case series until August 2021 found through PubMed, Google Scholar, and Scopus. A total of 94 cotyledonoid leiomyomas were reported, with a median tumor size of 12 cm. The typical ultrasound image is characterized by a large solid heterogeneous mass, with high vascularity, no shadowing, and indistinct margins within the myometrium. Magnetic resonance imaging shows the presence of merging isointense nodules to the myometrium in T1-weighted images, hyperintense in T2-weighted images, and contrast agent enhancement. Surgical treatment consists of hysterectomy (75 cases, 80%) or myomectomy (19 cases, 20%), without evidence of recurrence if complete. The placenta-like appearance observed during surgery supports this rare fibroid hypothesis. The intraoperative frozen section can be considered. Microscopically, no atypical cells, signs of mitotic activity or cell necrosis are found. To conclude, some preoperative and intraoperative aspects of this lesion are distinctive and may lead surgeons to opt for conservative surgery.

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Cotyledonoid Dissecting Leiomyoma of the Uterus: An Unexpected Diagnosis After Delivery

Cited by 3 publications

References 8 publications

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

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

Cotyledonoid dissecting leiomyoma of the uterus: a case report and review of the literature

The Management of the Cotyledonoid Leiomyoma of the Uterus: A Narrative Review of the Literature

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