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Open Access Highly Accessed Case Report

Cotyledonoid dissecting leiomyoma of the uterus: a case report

Annikka Weissferdt1*, Madhavi B Maheshwari2, Gabrielle P Downey3, Terence P Rollason1 and Raji Ganesan1

Author affiliations

1 Department of Histopathology, Birmingham Women's Hospital, Metchley Park Road, Edgbaston, B15 2TG, UK

2 Department of Histopathology, Sandwell and West Birmingham Hospitals, Dudley Road, Birmingham, B18 7QH, UK

3 Department of Obstectrics and Gynaecology, Sandwell and West Birmingham Hospitals, Dudley Road, Birmingham, B18 7QH, UK

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Citation and License

Diagnostic Pathology 2007, 2:18  doi:10.1186/1746-1596-2-18

Published: 13 June 2007

Abstract

Cotyledonoid dissecting leiomyoma of the uterus is a recently described rare variant of benign uterine leiomyoma. We report a case of cotyledonoid dissecting leiomyoma in a 52 year old woman who presented with menorrhagia and abdominal pain. An ultrasound scan showed a bulky uterus and a cystic heterogenous mass near the left ovary. At hysterectomy, the left broad ligament mass was removed. This was continuous with an ill-defined nodular area in the myometrial fundus. Microscopy revealed a benign smooth muscle proliferation in the myometrium that extended beyond the uterus and into the broad ligament. The lesion appeared to be dissecting the myometrial fibres and showed areas of oedema, hyalinisation and perinodular hydropic change. Cellular atypia, mitoses and coagulative necrosis were absent. The patient is alive and well 18 months after surgery. It is important to recognize this benign and unusual appearing variant of leiomyoma in order to prevent inappropriate treatment.