Gurbuz A, Karateke A, Kabaca C, Arik H, Bilgic R
Department of Obstetrics and Gynecology, Zeynep Kamil Women and Children Diseases Education and Research Hospital, Uskudar, Istanbul, Turkey.
Int J Gynecol Cancer. 2005 Nov-Dec;15(6):1218-21. doi: 10.1111/j.1525-1438.2005.00181.x.
We report a case of a rare, unusual benign tumor, the cotyledonoid leiomyoma or Sternberg tumor, detected incidentally in a 67-year-old woman who underwent total hysterectomy and bilateral salpingo-oophorectomy because of a persisting left ovarian cyst of 5 cm. This is the 14th case of cotyledonoid leiomyoma and 2nd case which had no intrauterine portion but had extrauterine extensions. At laparotomy, it was detected that a deep red nodular papillary tumor had been dissecting the posterior leaf of the left broad ligament, projecting into the abdominal cavity just near the left cornu of the uterus, and extending in downward direction. The remaining portion was lying between the layers of the left broad ligament and arose from the subserosa of the left side of the uterine isthmus. Although the bizarre and unusual shape was in favor of malignity, the frozen-section examination revealed a benign histology. Although the cotyledonoid leiomyoma is a benign entity, it may suggest a malignant disease owing to its unusual sarcomatoid appearance and its rarity. Therefore, awareness of obstetricians and gynecologists regarding this rare entity will prevent unnecessary anxiety and interventions.
我们报告一例罕见的不寻常良性肿瘤——子叶状平滑肌瘤或施特恩贝格瘤,该病例偶然发现于一名67岁女性,她因持续存在的5厘米左侧卵巢囊肿接受了全子宫切除术和双侧输卵管卵巢切除术。这是第14例子叶状平滑肌瘤病例,也是第2例无子宫内部分但有子宫外延伸的病例。在剖腹手术中,发现一个深红色结节状乳头状肿瘤正在分离左侧阔韧带后叶,突出于子宫左角附近的腹腔内,并向下延伸。其余部分位于左侧阔韧带两层之间,起源于子宫峡部左侧的浆膜下。尽管其奇异和不寻常的形状提示恶性,但冰冻切片检查显示为良性组织学。尽管子叶状平滑肌瘤是一种良性病变,但由于其不寻常的肉瘤样外观和罕见性,可能提示恶性疾病。因此,妇产科医生对这种罕见病变的认识将避免不必要的焦虑和干预。