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Review

The Management of the Cotyledonoid Leiomyoma of the Uterus: A Narrative Review of the Literature

1
Institute for Maternal and Child Health, I.R.C.C.S. “Burlo Garofolo”, 34137 Trieste, Italy
2
Department of Medical, Surgical and Health Science, University of Trieste, 34127 Trieste, Italy
3
Centro di Riferimento Oncologico di Aviano (C.R.O.), I.R.C.C.S., 33081 Aviano, Italy
*
Author to whom correspondence should be addressed.
Academic Editors: Milan Terzic, Antonio Simone Laganà and Antonio Sarria-Santamera
Int. J. Environ. Res. Public Health 2021, 18(16), 8521; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18168521
Received: 12 July 2021 / Revised: 5 August 2021 / Accepted: 9 August 2021 / Published: 12 August 2021
(This article belongs to the Special Issue Women Health and Gynecology)
Cotyledonoid leiomyoma is an unusual uterine myoma due to some ultrasound features that mimic a malignant lesion facilitating the choice of radical surgery. This study aims to summarize the ultrasound and the magnetic resonance imaging aspects of this atypical lesion, and also discuss surgical treatment and pathological exam. It included all English case reports or case series until August 2021 found through PubMed, Google Scholar, and Scopus. A total of 94 cotyledonoid leiomyomas were reported, with a median tumor size of 12 cm. The typical ultrasound image is characterized by a large solid heterogeneous mass, with high vascularity, no shadowing, and indistinct margins within the myometrium. Magnetic resonance imaging shows the presence of merging isointense nodules to the myometrium in T1-weighted images, hyperintense in T2-weighted images, and contrast agent enhancement. Surgical treatment consists of hysterectomy (75 cases, 80%) or myomectomy (19 cases, 20%), without evidence of recurrence if complete. The placenta-like appearance observed during surgery supports this rare fibroid hypothesis. The intraoperative frozen section can be considered. Microscopically, no atypical cells, signs of mitotic activity or cell necrosis are found. To conclude, some preoperative and intraoperative aspects of this lesion are distinctive and may lead surgeons to opt for conservative surgery. View Full-Text
Keywords: cotyledonoid; leiomyoma; US; MRI cotyledonoid; leiomyoma; US; MRI
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MDPI and ACS Style

Buonomo, F.; Bussolaro, S.; Fiorillo, C.d.A.; Giorda, G.; Romano, F.; Biffi, S.; Ricci, G. The Management of the Cotyledonoid Leiomyoma of the Uterus: A Narrative Review of the Literature. Int. J. Environ. Res. Public Health 2021, 18, 8521. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18168521

AMA Style

Buonomo F, Bussolaro S, Fiorillo CdA, Giorda G, Romano F, Biffi S, Ricci G. The Management of the Cotyledonoid Leiomyoma of the Uterus: A Narrative Review of the Literature. International Journal of Environmental Research and Public Health. 2021; 18(16):8521. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18168521

Chicago/Turabian Style

Buonomo, Francesca, Sofia Bussolaro, Clarice d.A. Fiorillo, Giorgio Giorda, Federico Romano, Stefania Biffi, and Giuseppe Ricci. 2021. "The Management of the Cotyledonoid Leiomyoma of the Uterus: A Narrative Review of the Literature" International Journal of Environmental Research and Public Health 18, no. 16: 8521. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18168521

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