Cotyledonoid dissecting leiomyoma ("Sternberg tumor") is an unusual type of a benign uterine smooth-muscle tumor with a distinctive gross appearance. A 57-year-old woman (gravida 7, para 6), in menopause for 3 years, presented with a 3-4-year history of increased pelvic pain. The transvaginal ultrasound scan showed a 2.5 cm sized heterogenic mass in the uterus cavity and 4 × 5 cm sized irregular contoured mass in the right lateral aspect of the uterus. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed with removal of the pelvic tumor extension. Definite pathologic examination result was cotyledonoid dissecting leiomyoma of the uterus with intravascular growth. The patient is receiving follow-up care every 6 months, and she has no evidence of disease after 22 months of follow-up. The worrying appearance of the gross specimen is often mistaken for malignant or non-uterine lesions that may result in overtreatment. It is important to be aware of this entity to prevent overly aggressive treatment for this benign smooth-muscle neoplasm.

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http://dx.doi.org/10.1007/s10147-011-0184-8DOI Listing

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Article Synopsis
  • Leiomyomas are non-cancerous tumors of the uterine smooth muscle that can have various forms and are known to undergo secondary changes, sometimes resembling more serious conditions.
  • A rare type called cotyledonoid dissecting leiomyoma (CDL) can appear as large, abnormal masses, leading to misdiagnosis as cancer due to its size and complexity.
  • The article includes a case study of a 65-year-old woman with CDL, highlighting the need for awareness among healthcare professionals to prevent unnecessary aggressive treatments.
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Cotyledonoid dissecting leiomyoma (CDL) is a rare benign uterine leiomyoma that macroscopically shows multinodular placenta-like growth. Its border with the myometrial layer is unclear, making it clinically difficult to differentiate from uterine sarcoma. CDL is often misdiagnosed.

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Article Synopsis
  • Cotyledonoid-dissecting leiomyoma is a rare type of uterine tumor that can be mistaken for cancer.
  • A case involved a 45-year-old woman who had a large pelvic mass, which was successfully diagnosed as this specific type of leiomyoma through laparoscopic biopsy.
  • The use of leuprorelin, a medication that reduces tumor size, prior to surgery demonstrated a significant decrease in the tumor, highlighting the benefits of minimally invasive diagnostic methods and preoperative treatment.
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