Tanaka Hirohiko, Toriyabe Kuniaki, Senda Tokihiro, Sakakura Yasufumi, Yoshida Kayo, Asakura Tetsuo, Taniguchi Haruki, Nagao Kenji
Department of Obstetrics and Gynecology, Mie Prefectural General Medical Center, Yokkaichi, Japan.
Asian J Endosc Surg. 2013 May;6(2):122-5. doi: 10.1111/ases.12009.
A cotyledonoid dissecting leiomyoma is categorized as a leiomyoma with an unusual growth pattern, which is characterized by remarkable extrauterine bulbous growth in continuity with a dissecting myometrial component. A 36-year-old patient was preoperatively diagnosed with a mature cystic teratoma of the left ovary, and according to MRI, the tumor protruded from the uterus into the right broad ligament and was 10 cm in diameter. She underwent laparoscopic surgery to resect ovarian teratoma and the tumor under the right broad ligament. The tumor was almost completely resected and diagnosed as a cotyledonoid dissecting leiomyoma based on intraoperative and pathological findings. Recurrence was not seen for 26 months postoperatively in our case. Gross specimens are often mistaken for malignant lesions, but this was a benign disease. Even if some remnants of the leiomyoma remained postoperatively, recurrence has never been reported. When a cotyledonoid dissecting leiomyoma is resected laparoscopically, intrapelvic structures around it, such as the ureter, uterine artery, bladder, rectum and external iliac vessels, must be given careful attention.
分叶状浸润性平滑肌瘤被归类为具有异常生长模式的平滑肌瘤，其特征是与浸润性肌层成分连续的显著子宫外球样生长。一名36岁患者术前被诊断为左卵巢成熟囊性畸胎瘤，根据磁共振成像（MRI）显示，肿瘤从子宫突出至右侧阔韧带，直径为10厘米。她接受了腹腔镜手术以切除卵巢畸胎瘤及右侧阔韧带下方的肿瘤。肿瘤几乎被完全切除，根据术中及病理结果诊断为分叶状浸润性平滑肌瘤。在我们的病例中，术后26个月未见复发。大体标本常被误诊为恶性病变，但这是一种良性疾病。即使术后残留一些平滑肌瘤组织，也从未有过复发的报道。当通过腹腔镜切除分叶状浸润性平滑肌瘤时，必须仔细关注其周围的盆腔内结构，如输尿管、子宫动脉、膀胱、直肠和髂外血管。
