Cotyledonoid leiomyoma of the uterus: Report of a case

A 16-year-old woman presented with a pelvic mass. At the time of operation a large, exophytic, multinodular tumor extended into the peritoneal cavity and right broad ligament from a pedunculated attachment to the uterus in th e region of the right cornu. On external examination the lesion had the app earance of cotyledonoid dissecting leiomyoma. On microscopic examination bu lbous processes were composed of benign smooth muscle arranged in interlaci ng fascicles or swirls; there was focal hydropic degeneration. Significant nuclear atypia, mitotic activity, and coagulative tumor necrosis were not e ncountered. No intravascular involvement was present. There was no demonstr able parent leiomyoma or intramural dissecting component, and thus the case differed from previously reported cases of both cotyledonoid dissecting le iomyoma and intramural dissecting leiomyoma. This tumor represents another variation in the group of benign uterine smooth muscle tumors with unusual growth patterns.