Cotyledonoid dissecting leiomyoma of the uterus: a gross and radiologic malignancy mimicker

• Published in: International journal of gynecological cancer Vol. 33; no. 11; pp. 1827 - 1829
• Main Authors: Abreu, Rodrigo Fonseca, Bovolim, Graziele, Baiocchi, Glauco, De Brot, Louise
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd 01.11.2023; BMJ Publishing Group LTD
• Subjects: Fibroids; Magnetic resonance imaging; Ovaries; Pathology archives; Smooth muscle; Tumors; Uterine cancer; Uterine Neoplasms; Uterus; Uterus; Uterine Neoplasms
• ISSN: 1048-891X; 1525-1438
• DOI: 10.1136/ijgc-2022-004119

Magnetic resonance imaging of the pelvis showing a large irregular mass. Because of a suspicion of malignancy, a diagnostic and therapeutic procedure was carried out. Cotyledonoid dissecting leiomyoma of the uterus is a rare benign smooth muscle uterine tumor, considered a leiomyoma variant, with <60 cases reported in the literature.1–4 Due to its multinodular appearance, constituting solid projections amid a loose, sometimes hyalinized, and vascularized stroma, it can simulate malignant lesions on gross and radiological examination.1 For the pathological diagnosis, it is only necessary to examine the morphological patterns observed in gross examination and histological features seen through hematoxylin–eosin stained slides.1–4 These tumors can extend outside the uterus and can have intravenous extension. Leiomyosarcoma is a malignant neoplasm composed of cells with smooth muscle differentiation, moderate to severe cytological atypia, more prominent mitotic activity, necrosis, frequent local recurrence, distant metastasis, and death related to the disease.1 2 In conclusion, cotyledonoid dissecting leiomyoma of the uterus can be a diagnostic pitfall because it can mimic malignancies.