en Obstetrics and Gynecology Obstetrics and Gynecology گزارش مورد Case Report <div style="text-align: justify;"><span style="font-size:11pt"><span style="line-height:14.0pt"><span style="text-autospace:none"><span calibri="" style="font-family:"><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">&nbsp;Leiomyomas, benign smooth muscle tumors of the uterus, commonly present with bleeding and are known for their varied morphology. This case report highlights a rare variant, Cotyledonoid dissecting leiomyoma, which poses diagnostic challenges due to its unusual appearance and growth pattern, often mimicking malignancy</span></span></span></span></span></span><br /> <span style="font-size:11pt"><span style="line-height:14.0pt"><span style="text-autospace:none"><span calibri="" style="font-family:"><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">We present the case of a 65-year-old female with clinical symptoms of pain, urinary retention, and bleeding, who underwent total abdominal hysterectomy. Gross examination revealed a large mass with lobulated patterns, raising concerns for malignancy. Microscopic examination, however, revealed characteristic features of Cotyledonoid dissecting leiomyoma, including nodular growth and dissection within the myometrium without atypical or mitosis.</span></span></span></span></span></span><br /> <span style="font-size:11pt"><span style="line-height:14.0pt"><span style="text-autospace:none"><span calibri="" style="font-family:"><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">&nbsp;Our literature review identified only 28 reported cases of this variant, emphasizing its rarity and diagnostic importance. Clinicians and pathologists must be aware of this entity to avoid unnecessary overtreatment. </span></span></span></span></span></span><br /> <span style="font-size:11pt"><span style="line-height:14.0pt"><span style="text-autospace:none"><span calibri="" style="font-family:"><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">Frozen sections may aid in accurate diagnosis, particularly to preserve fertility in young women. While leiomyomas are predominantly conventional, rare subtypes like Cotyledonoid dissecting leiomyoma warrant recognition to prevent misdiagnosis and ensure appropriate management. This case underscores the importance of histopathological evaluation in guiding clinical decisions for patients with unusual uterine tumors.</span></span></span></span></span></span></div> Cotyledonoid dissecting leiomyoma, Histopathological evaluation, Leiomyomas, Uterine tumors 1 4 http://caspjrm.ir/browse.php?a_code=A-12-149-2&slc_lang=en&sid=1 Alka Yadav dr.alkayadav080989@gmail.com 10031947532846002535 10031947532846002535 Yes Department of Pathology, Uttar Pradesh University of Medical Sciences Saifai, India Sujata Raychaudhuri 10031947532846002536 10031947532846002536 No Lakshinder Kaur 10031947532846002537 10031947532846002537 No Minakshi Bhardwaj 10031947532846002538 10031947532846002538 No