Yadav Alka, Raychauduri Sujata, Kaur Lakshinder, Wadhwa Ruchira, Bhardwaj Minakshi
Department of Pathology, Uttar Pradesh University of Medical Sciences, Saifai, Uttar Pradesh, India.
Department of Pathology, Esic Medical College and Hospital, Faridabad, Haryana, India.
J Midlife Health. 2024 Jul-Sep;15(3):197-200. doi: 10.4103/jmh.jmh_15_24. Epub 2024 Oct 17.
Leiomyomas are benign smooth muscle tumor of the uterus with varied morphology that are well known to undergo secondary changes. A variety of other unusual patterns of uterine leiomyoma have been described, such as parasitic leiomyoma, cellular leiomyoma, symplastic or bizarre leiomyoma, epithelioid leiomyoma, intravenous leiomyomatosis, and leiomyoma with secondary changes. Some cotyledonoid dissecting leiomyoma (CDL) appears as large fungating masses with widespread extension into the broad ligament and pelvic cavity. Due to its rarity and a clinician's lack of familiarity, such tumors are sometimes misdiagnosed as malignancies. We present a rare case report of CDL. It is a diagnostic challenge for clinicians, pathologists, and radiologists and can be confused with malignancy due to its large size. After extensive literature research, we found 28 case reports of this variant. Little is known in the literature about this entity. We present here a case report of a 65-year-old female emphasizing its clinical, radiological, gross, and microscopic findings. A total hysterectomy was performed on the patient. This tumor does not have malignant potential, but clinicians and pathologists must be aware of its existence to avoid over-treating patients as malignancy.
平滑肌瘤是子宫的良性平滑肌肿瘤，形态多样，众所周知会发生继发性改变。已经描述了多种其他不寻常的子宫平滑肌瘤模式，如寄生性平滑肌瘤、细胞性平滑肌瘤、合体细胞性或奇异型平滑肌瘤、上皮样平滑肌瘤、静脉内平滑肌瘤病以及伴有继发性改变的平滑肌瘤。一些分叶状弥漫性平滑肌瘤（CDL）表现为巨大的外生性肿块，广泛延伸至阔韧带和盆腔。由于其罕见性以及临床医生对此缺乏了解，此类肿瘤有时会被误诊为恶性肿瘤。我们报告一例罕见的CDL病例。对于临床医生、病理学家和放射科医生来说，这是一个诊断挑战，因其体积较大，可能会与恶性肿瘤混淆。经过广泛的文献研究，我们发现了28例关于这种变体的病例报告。文献中对该实体了解甚少。我们在此报告一例65岁女性的病例，重点介绍其临床、放射学、大体和显微镜下表现。对该患者实施了全子宫切除术。这种肿瘤没有恶性潜能，但临床医生和病理学家必须意识到它的存在，以避免将患者过度治疗为恶性肿瘤。
