Xu Tianmin, Wu Shuying, Yang Rulin, Zhao Liping, Sui Mingxing, Cui Manhua, Chang Weiqin
Department of Obstetrics and Gynecology, The Second Hospital of Jilin University, Changchun, Jilin 130041, P.R. China.
Department of General Surgery, The Second Hospital of Jilin University, Changchun, Jilin 130041, P.R. China.
Oncol Lett. 2016 Apr;11(4):2865-2868. doi: 10.3892/ol.2016.4314. Epub 2016 Mar 8.
Cotyledonoid dissecting leiomyoma (CDL), also termed Sternberg tumor, is a variant of uterine leiomyoma that is rarely diagnosed by clinical evaluation. At present, ~43 cases of CDL have been reported in the literature written in the English language. Due to the distinctive grapelike gross appearance of an exophytic mass resembles placental tissue, CDL is often misdiagnosed clinically as an ovarian tumor or uterine sarcoma. Therefore, an awareness of the features of the disease is important to prevent misdiagnosis and overtreatment. The present study reports 4 cases of CDL of the uterus that were treated at the Second Hospital of Jilin University between January 2009 and December 2011. All 4 patients in the current study presented with a palpable asymptomatic pelvic mass, which was detected during physical examinations, and cancer antigen 125 tumor marker levels that were within the normal range. The exploratory laparotomy of the 4 patients revealed lobulated tumors with a grapelike appearance extending from the lateral uterine wall into the ligament or the adjacent tissues. The frozen section and postoperative pathology were diagnosed as CDL. A total abdominal hysterectomy was performed in the first case of a 55-year-old woman that had been in menopause for 7 years. The patient was well and showed no evidence of disease subsequent to 48 months of follow-up. A total abdominal hysterectomy and right salpingo-oophorectomy were performed in the second case of a 43-year-old woman, who was well and showed no evidence of disease subsequent to 26 months of follow-up. A subtotal abdominal hysterectomy and bilateral salpingectomy were performed in the third case of a 37-year-old woman, who was well and showed no evidence of disease subsequent to 27 months of follow-up. A total abdominal hysterectomy and right-salpingectomy were performed with the removal of a retroperitoneal fibroid extension in the fourth case of a 48-year-old woman, who was well and showed no evidence of disease subsequent to 32 months of follow-up.
子叶状剥脱性平滑肌瘤（CDL），也称为施特恩贝格瘤，是子宫平滑肌瘤的一种变体，临床评估很少能诊断出来。目前，英文文献中已报道约43例CDL。由于外生性肿块独特的葡萄样外观类似于胎盘组织，CDL在临床上常被误诊为卵巢肿瘤或子宫肉瘤。因此，了解该疾病的特征对于防止误诊和过度治疗很重要。本研究报告了2009年1月至2011年12月在吉林大学第二医院接受治疗的4例子宫CDL。本研究中的所有4例患者均表现为体格检查时可触及的无症状盆腔肿块，癌抗原125肿瘤标志物水平在正常范围内。4例患者的剖腹探查显示肿瘤呈分叶状，外观呈葡萄样，从子宫侧壁延伸至韧带或邻近组织。冰冻切片和术后病理诊断为CDL。第一例为一名55岁绝经7年的女性，行全腹子宫切除术。随访48个月后，患者情况良好，无疾病迹象。第二例为一名43岁女性，行全腹子宫切除术和右侧输卵管卵巢切除术，随访26个月后，患者情况良好，无疾病迹象。第三例为一名37岁女性，行次全腹子宫切除术和双侧输卵管切除术，随访27个月后，患者情况良好，无疾病迹象。第四例为一名48岁女性，行全腹子宫切除术和右侧输卵管切除术，并切除腹膜后肌瘤延伸部分，随访32个月后，患者情况良好，无疾病迹象。
