Recurrent cotyledonoid dissecting leiomyoma of the uterus.

Cotyledonoid dissecting leiomyoma is a benign smooth muscle neoplasm with an unusual growth pattern that is characterized by intramural dissection within the uterine corpus and often a placental-like appearance macroscopically in its extrauterine component that may be alarming to the surgeon. All cases reported to date have been nonaggressive. We report a case in a 33-yr-old woman who had a history of prolonged uterine bleeding. She was operated upon for uterine leiomyomas, and the diagnosis of cotyledonoid dissecting leiomyoma was made at the time of intraoperative consultation. To maintain fertility, the intrauterine tumor was resected by myomectomy and the extrauterine tumor by excision. However, persistent uterine bleeding that eventually became intractable and continued growth of the neoplasm in the uterus necessitated hysterectomy 5 yr later. She was living and well 2.5 yr after hysterectomy with no evidence of disease.

Malignant Brenner tumor of the ovary with transformation to trabecular carcinoid: an immunocytochemical and electron microscopic study.

Ovarian Brenner tumors are typically of surface epithelial-stromal origin; however, cases associated with mature cystic teratoma and/or struma ovarii possibly have a teratomatous derivation. Although argyrophil cells have been described in ovarian Brenner tumors and in urinary bladder epithelium, we are not aware of any previous reports of carcinoid arising from a malignant Brenner tumor of the ovary. In this study, we describe an 85-year-old woman who had a low-grade malignant Brenner tumor with progressive proliferation of neuroendocrine cells and transformation to trabecular carcinoid as demonstrated by immunocytochemistry and electron microscopy.