Cotyledonoid dissecting leiomyoma of the uterus: a report of four cases

Abstract

Abstract Introduction: Some variant forms of uterine leiomyoma with unusual infiltrative growth patterns have been known, including intravenous leiomyomatosis, diffuse leiomyomatosis, leiomyoma with vascular invasion, and disseminated peritoneal leiomyomatosis. Cotyledonoid dissecting leiomyoma was proposed as a new form of uterine leiomyoma with distinctive and alarming gross features resembling cotyledons of the placenta but with a benign histology. Cases: We report four new cases of this distinctive benign uterine tumor with unusual growth patterns. We aim to analyze the distinctive gross and histological features of cotylodonoid dissecting leiomyoma in order to avoid overtreatment of this benign tumor, especially for patients of reproductive age. All the patients in our series were of reproductive or perimenopausal age (range 36–51 years), and had an enlarged uterus or a pelvic mass and abnormal uterine bleeding. On gross examination, the lesions had an unusual appearance and were often lobulated with...