Fernandez Kamilah, Cheung Laraine, Taddesse-Heath Lekidelu
Pathology and Laboratory Medicine, Howard University Hospital, Washington DC, USA.
Pathology and Laboratory Medicine, Howard University College of Medicine, Washington DC, USA.
Cureus. 2022 Oct 16;14(10):e30352. doi: 10.7759/cureus.30352. eCollection 2022 Oct.
Cotyledonoid dissecting leiomyoma is a rare variant of leiomyoma and has only been reported a few times in the literature. As a result of its alarming gross and radiologic appearance, it must be differentiated from other malignant smooth muscle tumors. We report a case of cotyledonoid dissecting leiomyoma in an African American premenopausal woman with a medical history of anemia, abnormal uterine bleeding, and a cervical mass. A total hysterectomy was performed on the patient. On pathological examination, the gross and microscopic appearance of the tumor was consistent with that described in previous reports of cotyledonoid dissecting leiomyoma. However, our case showed focal areas of increased mitotic activity with 5 mitoses per high power field but no tumor cell necrosis or cellular atypia. This tumor does not have malignant potential, but clinicians and pathologists must be aware of its existence to avoid overtreating patients.
子叶状分割性平滑肌瘤是平滑肌瘤的一种罕见变体，在文献中仅有少数报道。由于其令人担忧的大体和放射学表现，它必须与其他恶性平滑肌肿瘤相鉴别。我们报告一例子叶状分割性平滑肌瘤病例，患者为一名非裔美国绝经前女性，有贫血、异常子宫出血和宫颈肿物病史。对该患者实施了全子宫切除术。病理检查显示，肿瘤的大体和显微镜下表现与先前子叶状分割性平滑肌瘤报道中所描述的一致。然而，我们的病例显示有局灶性有丝分裂活性增加，每高倍视野有5个有丝分裂象，但无肿瘤细胞坏死或细胞异型性。这种肿瘤没有恶性潜能，但临床医生和病理学家必须知晓其存在，以避免过度治疗患者。
