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Cotyledonoid dissecting leiomyoma treated by laparoscopic surgery: a case report
Hirohiko Tanaka1, Kuniaki Toriyabe, Tokihiro Senda
1Department of Obstetrics and Gynecology, Mie Prefectural General Medical Center, Yokkaichi, Japan. htanaka1576@excite.co.jp
Asian Journal of Endoscopic Surgery
|April 23, 2013
Summary
A rare cotyledonoid dissecting leiomyoma, a benign uterine tumor with unusual growth, was successfully resected laparoscopically. This case highlights the importance of careful surgical technique to avoid damage to surrounding pelvic structures.
Area of Science:
- Gynecologic Oncology
- Surgical Pathology
- Reproductive Medicine
Background:
- Leiomyomas are common benign uterine tumors, but the cotyledonoid dissecting leiomyoma variant presents with unusual extrauterine growth.
- Accurate preoperative diagnosis can be challenging, often requiring advanced imaging like MRI.
Observation:
- A 36-year-old patient presented with a large (10 cm) tumor in the left ovary, suspected to be a mature cystic teratoma.
- MRI revealed the tumor extending from the uterus into the right broad ligament.
Findings:
- Laparoscopic resection of the ovarian teratoma and the broad ligament tumor was performed.
- Pathological examination confirmed the diagnosis of cotyledonoid dissecting leiomyoma, a benign entity.
- No recurrence was observed during a 26-month follow-up period.
Implications:
- Cotyledonoid dissecting leiomyomas, despite their concerning appearance, are benign and rarely recur.
- Laparoscopic resection requires meticulous attention to adjacent pelvic structures, including the ureter, uterine artery, bladder, rectum, and external iliac vessels.
- This case underscores the successful management of a rare leiomyoma variant through minimally invasive surgery.