Here, we report the case of a 43-year-old female who was diagnosed with a cotyledonoid dissecting leiomyoma (CDL) of the uterus. CDL is a recently described and extremely rare variant of a benign leiomyoma that can grossly masquerade as a malignancy. The 13-cm sized tumor was located primarily on the extrauterine surface as an intrauterine continuity, which showed dark red, congested, bulbous protuberances. It was multinodular appearance, encasing the bilateral adnexae and the left iliac vein. Microscopically, the nodules were separated by extensive hydropic degeneration. The nodules were composed of cigar-shaped spindle cells with no mitosis, cellular pleomorphism or coagulation necrosis. They also showed an intravascular luminal growth pattern. CDL with intravascular growth was diagnosed after excluding intravascular leiomyomatosis, disseminated peritoneal leiomyomatosis, and benign metastasizing leiomyoma. The present case is the second reported case of CDL in Korea. Recognition of this rare and bizarre, malignancy-mimicking leiomyoma is crucial to prevent inappropriate treatment.

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• Cotyledonoid dissecting leiomyoma of the uterus: a case report and review of the literature
  Mahboobeh Chahkandi, Marzieh Ataei, Amir Reza Bina, Farnaz Mozayani, Ali Fanoodi
  Journal of Medical Case Reports.2023;[Epub]     CrossRef
• Cotyledonoid Leiomyoma Clinical Characteristics, Imaging Features, and Review of the Literature
  Francesca Buonomo, Sofia Bussolaro, Giorgio Giorda, Federico Romano, Stefania Biffi, Giuseppe Ricci
  Journal of Ultrasound in Medicine.2021; 40(7): 1459.     CrossRef
• The Management of the Cotyledonoid Leiomyoma of the Uterus: A Narrative Review of the Literature
  Francesca Buonomo, Sofia Bussolaro, Clarice de Almeida Fiorillo, Giorgio Giorda, Federico Romano, Stefania Biffi, Giuseppe Ricci
  International Journal of Environmental Research and Public Health.2021; 18(16): 8521.     CrossRef
• Cotyledonoid dissecting leiomyoma of the uterus: A report of four cases and a review of the literature
  TIANMIN XU, SHUYING WU, RULIN YANG, LIPING ZHAO, MINGXING SUI, MANHUA CUI, WEIQIN CHANG
  Oncology Letters.2016; 11(4): 2865.     CrossRef
• COTYLEDONOID DISSECTING LEIOMYOMA (CDL) OF UTERUS MIMICKING MALIGNANCY: A CLINICAL DILEMMA
  Roma Isaacs, Rupinder Kaur, Sunita Goyal
  Journal of Evolution of Medical and Dental Sciences.2016; 5(57): 3973.     CrossRef