Cotyledonoid leiomyoma of uterus: a case report

Ersöz, Şafak; Turgutalp, Havvanur; Munğan, Sevdegül; Güvendi, Gülname Fındık; Güven, Süleyman

doi:10.5146/tjpath.2011.01085

Cited by 9 publications

(14 citation statements)

References 6 publications

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“…CDL was first reported and named by Roth et al (1) (19). According to the presentation of the intramural dissection or extrauterine extension, CDL is also classified as dissecting leiomyoma, cotyledonoid dissecting leiomyoma or cotyledonoid leiomyoma (1).…”

Section: Discussionmentioning

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

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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.

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Section: Discussionmentioning

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

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“…CDL commonly arises from the fundus or posterior aspect of cornu uterus and is characterized by reddish, exophytic, expansile, spongy, bulbous, placenta-like gross appearance by its extrauterine extension into the pelvic cavity raising possibility of malignancy intraoperatively. [1][2][3][4][5][6][7][8][9][10][11][12] which was seen in our case. The dark red appearance of exophytic component is due to venous obstruction and congestion with tan white endophytic parent intramural leiomyoma.…”

Section: Discussionmentioning

confidence: 55%

“…The tumour size ranges from 4-41 cms (mean 15.4 cms) with no side predilection and may even be bilateral. 1,2,3,8 Microscopically, the tumour is composed of variable sized micronodules of muscle fascicles with marked hydropic change. The tumour shows very minimal or no cellular atypia with no increase in mitotic activity (<1 mitosis/10 HPF) or CTN.…”

Section: Discussionmentioning

confidence: 99%

“…2 It exhibits infiltrative pattern resembling malignant tumour on both macro and microscopic evaluation. 3 Worrisome appearance of this lesion can lead to overtreatment by hysterectomy, especially in females of reproductive age group. 4 Here, we report a case of infiltrative cotyledonoid leiomyoma presenting as a malignant exophytic growth in the uterus.…”

Section: Introductionmentioning

confidence: 99%

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Cotyledonoid Dissecting Leiomyoma (Cdl) of Uterus Mimicking Malignancy: A Clinical Dilemma

Isaacs¹,

Kaur²

2016

jemds

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“…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. CDLs are seen in women of reproductive or postmenopausal age group [8] and have a wide age range of 23 to 65 years (mean 40.3 years). The majority of patients are admitted to hospital with palpable uterine masses and abnormal uterine bleeding.…”

Section: Discussionmentioning

confidence: 99%

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

Merchant

Chern

Chew

2017

CRCP

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Cotyledonoid dissecting leiomyoma (CDL) is a rare variant of leiomyoma which shows a dissecting growth pattern of smooth muscle cells within the myometrium, with or without extra-uterine extension, and a macroscopic appearance resembling placenta. We present a unique case of CDL with both intravascular growth and presence of endometrial glands and stroma within the tumour. A 35-year-old female patient presented with menorrhagia. Ultrasound examination revealed a bulky anteverted uterus with a prolapsed submucosal leiomyoma and an intramural leiomyoma. In the interest of preserving fertility, she underwent myomectomy together with laparoscopic resections of the uterine wall deposit and myometrial tissue. The tumour was soft and pink, with a resemblance to placental tissue, and histology demonstrated nodules of neoplastic smooth muscle cells with areas of oedema and myxoid change dissecting into the surrounding myometrial tissue, which is consistent with the features of CDL. Also seen were non-neoplastic endometrial glands cuffed by stroma located within the smooth muscle tumour as well as in the non-neoplastic myometrium. There were foci of intravascular luminal growth confirmed by positive CD31 immunohistochemical staining of the endothelial cells lining the vascular lumina. The present case demonstrates that CDLs may have a unique histological appearance resembling adenomyoma and an intravascular growth pattern. It is important for pathologists, gynaecologists and radiologists to recognize such smooth muscle tumour variants and hence prevent misdiagnosis of malignancy and overtreatment.

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Cotyledonoid leiomyoma of uterus: a case report

Cited by 9 publications

References 6 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 Dissecting Leiomyoma (Cdl) of Uterus Mimicking Malignancy: A Clinical Dilemma

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

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