A Rare Coexistence: Uterine Leiomyoma Arising in a Mature Cystic Teratoma and a Pedunculated Endometriotic Cyst Mimicking Leiomyoma—Two Case Reports

Uterine leiomyomas are common benign tumors, but their clinical presentation can be misleading. We report two unusual cases of pedunculated uterine masses presenting with heavy vaginal bleeding. In the first case, a woman in her 40s underwent urgent resection of a prolapsing mass after acute hemorrhage; histopathological examination demonstrated a mature cystic teratoma containing a leiomyomatous component, an exceptionally rare finding. In the second case, a woman in her late 40s presented with a pedunculated cervical mass initially considered to be a leiomyoma; histopathology instead showed an endometriotic cyst with no definitive evidence of leiomyoma. These cases emphasize that apparently typical prolapsing uterine masses may conceal rare pathological entities and highlight the importance of comprehensive histopathological assessment for accurate diagnosis, counseling, and management.