Unraveling the Rare Case Report of Cotyledonoid Dissecting Leiomyoma in Gynecology

Aim and background: Cotyledonoid dissecting leiomyoma (CDL) is an uncommon condition that may manifest as a malignant tumor and can pose diagnostic challenges for gynecologists, radiologists, and pathologists.It is a type of uterine smooth muscle tumor characterized by an atypical growth pattern that exhibits intramural dissection within the myometrium and frequently resembles placental tissue in its extrauterine parts.Case description: We present a unique case of CDL with adenomyosis.A 42-year-old female presented with lower abdominal pain.A 7.5 × 20 × 25 cm 3 sheet-like solid mass -from pelvis into abdominal cavity -was found by magnetic resonance imaging (MRI), and total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed.Histopathological report confirmed dissecting cotyledonoid leiomyoma.Conclusion: It is crucial to identify this uncommon variant of leiomyoma to avoid aggressive and unnecessary overdiagnosis and overtreatment.It is recommended to consider utilizing frozen sections for improved diagnosis and to maintain fertility in young women affected by this condition.Clinical significance: Healthcare professionals, including clinicians, radiologists, and pathologists, need to recognize this uncommon variant to diagnose and treat it accurately.Numerous published studies have detailed the clinical manifestations, diagnostic difficulties, and treatment approaches for improving the management of this disease.