Cotyledonoid leiomyoma in pregnancy

Area of Science:

• Gynecologic Oncology
• Reproductive Medicine
• Surgical Pathology

Background:

• Benign smooth-muscle tumors (leiomyomata) are common in the female genital tract.
• While typically diagnosed and managed conservatively during pregnancy, rare variants present diagnostic challenges.
• Unusual infiltrative growth patterns in leiomyomata can complicate management during gestation.

Observation:

• A rare cotyledonoid leiomyoma was identified, adhering to the bowels and occupying the broad ligament.
• This unusual leiomyoma was completely excised at 14 weeks of gestation.
• The pregnancy proceeded to term following the surgical intervention.

Findings:

• Complete excision of the cotyledonoid leiomyoma was feasible and successful early in pregnancy.
• The surgical management allowed the pregnancy to continue to term without apparent complications related to the tumor removal.
• This case demonstrates the possibility of managing rare leiomyoma variants surgically during pregnancy.

Implications:

• Enhanced awareness among gynecologists and pathologists regarding unusual leiomyoma variants is essential.
• Accurate diagnosis and understanding of rare benign smooth-muscle tumor growth patterns can prevent unnecessary aggressive treatments.
• This case contributes to the understanding of managing rare gynecologic tumors during pregnancy, emphasizing conservative yet definitive surgical approaches when indicated.