{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T21:19:32Z","timestamp":1768252772554,"version":"3.49.0"},"reference-count":66,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2021,8,12]],"date-time":"2021-08-12T00:00:00Z","timestamp":1628726400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.3390\/ijerph18168521","type":"journal-article","created":{"date-parts":[[2021,8,12]],"date-time":"2021-08-12T10:54:41Z","timestamp":1628765681000},"page":"8521","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["The Management of the Cotyledonoid Leiomyoma of the Uterus: A Narrative Review of the Literature"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6587-2622","authenticated-orcid":false,"given":"Francesca","family":"Buonomo","sequence":"first","affiliation":[{"name":"Institute for Maternal and Child Health, I.R.C.C.S. \u201cBurlo Garofolo\u201d, 34137 Trieste, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0273-5700","authenticated-orcid":false,"given":"Sofia","family":"Bussolaro","sequence":"additional","affiliation":[{"name":"Institute for Maternal and Child Health, I.R.C.C.S. \u201cBurlo Garofolo\u201d, 34137 Trieste, Italy"},{"name":"Department of Medical, Surgical and Health Science, University of Trieste, 34127 Trieste, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clarice de Almeida","family":"Fiorillo","sequence":"additional","affiliation":[{"name":"Institute for Maternal and Child Health, I.R.C.C.S. \u201cBurlo Garofolo\u201d, 34137 Trieste, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giorgio","family":"Giorda","sequence":"additional","affiliation":[{"name":"Centro di Riferimento Oncologico di Aviano (C.R.O.), I.R.C.C.S., 33081 Aviano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2157-8330","authenticated-orcid":false,"given":"Federico","family":"Romano","sequence":"additional","affiliation":[{"name":"Institute for Maternal and Child Health, I.R.C.C.S. \u201cBurlo Garofolo\u201d, 34137 Trieste, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefania","family":"Biffi","sequence":"additional","affiliation":[{"name":"Institute for Maternal and Child Health, I.R.C.C.S. \u201cBurlo Garofolo\u201d, 34137 Trieste, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8031-1102","authenticated-orcid":false,"given":"Giuseppe","family":"Ricci","sequence":"additional","affiliation":[{"name":"Institute for Maternal and Child Health, I.R.C.C.S. \u201cBurlo Garofolo\u201d, 34137 Trieste, Italy"},{"name":"Department of Medical, Surgical and Health Science, University of Trieste, 34127 Trieste, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,8,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1455","DOI":"10.1097\/00000478-199612000-00004","article-title":"Cotyledonoid Dissecting Leiomyoma of the Uterus. the Sternberg Tumor","volume":"20","author":"Roth","year":"1996","journal-title":"Am. 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