Uterine lipo-leiomyoma in post-menopausal women: two interesting cases

Authors

  • Heera Trivikrama Shenoy Department of Obstetrics and Gynecology, KMCT Medical College, Kozhikode, Kerala, India
  • Shibin Kambalavan Department of Obstetrics and Gynecology, KMCT Medical College, Kozhikode, Kerala, India
  • Shameema Puthuprakkat Department of Obstetrics and Gynecology, KMCT Medical College, Kozhikode, Kerala, India
  • Mary Nandini Singh Department of Pathology, KMCT Medical College, Kozhikode, Kerala, India
  • Athira Sasidharan Department of Pathology, KMCT Medical College, Kozhikode, Kerala, India
  • Jomy Perumcheril Thomas Department of Anaesthesiology, KMCT Medical College, Kozhikode, Kerala, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20222494

Keywords:

Benign, Lipoleiomyoma, Adipocytes, Smooth muscle, Uterine, post-menopausal

Abstract

Lipo-leiomyomas (LL), incidentally found lipomatous variants of uterine leiomyomas do not require surgical intervention unless symptomatic. Large LL of the uterine body is very rare. Majority being benign, these could co-exist with other gynaecological malignancies, metabolic diseases and abnormal oestrogen statuses and do rarely transform to liposarcoma. Here, we presented two interesting cases of postmenopausal women with LL. Ultrasonography and MRI performed in the workup of both, incidentally demonstrated a fatty lesion arising from the uterine corpus, consistent with a lipo-leiomyoma. This case report stresses the need for greater awareness of these variants regarding histogenesis, diagnosis and treatment.

Author Biography

Heera Trivikrama Shenoy, Department of Obstetrics and Gynecology, KMCT Medical College, Kozhikode, Kerala, India

Professor  in OBG  ,KMCT Medical college,Kozhikode,Kerala.

References

Brandfass RT, Everts-Suarez EA. Lipomatous tumors of the uterus; a review of the world's literature with report of a case of true lipoma. Am J Obstet Gynecol. 1955;70(2):359-67.

Willén R, Gad A, Willén H. Lipomatous lesions of the uterus. Virchows Arch A Pathol Anat Histol. 1978;377(4):351-61.

Lin M, Hanai J. Atypical lipoleiomyoma of the uterus. Acta Pathol Jpn. 1991;41(2):164-9.

Sharma S, Mandal AK. Uterine lipo-leiomyoma: A five year clinicopathological study. Ann Woman Child Health 2016;2:22- 6.

Haust MD, Heras J, Harding PG. Fat-containing uterine smooth muscle cells in "toxemia": possible relevance to atherosclerosis? Science. 1977;195(4284):1353-4.

Harada H, Tsuda Y, Yabuki K, Shiba E, Uchihashi K, Matsuyama A, et al. Inhibition of WNT/β-catenin signaling under serum starvation and hypoxia induces adipocytic transdifferentiation in human leiomyoma cells. Lab Invest. 2018;98(4):439-48.

Akbulut M, Gündoğan M, Yörükoğlu A. Clinical and pathological features of lipoleiomyoma of the uterine corpus: a review of 76 cases. Balkan Med J. 2014;31(3):224-9.

Zottola C, Lai E, Kwon SY. Lipoleimyoma masquerading as uterine prolapse. Int Urogynecol J. 2020;31(7):1487-8.

Adaikkalam J. Lipoleiomyoma of Cervix. J Clin Diagn Res. 2016;10(4):1-2.

Prieto A, Crespo C, Pardo A, Docal I, Calzada J, Alonso P. Uterine lipoleiomyomas: US and CT findings. Abdom Imaging. 2000;25(6):655-7.

Hashiguchi J, Ito M, Kishikawa M, Sekine I, Kase Y. Intravascular leiomyomatosis with uterine lipoleiomyoma. Gynecol Oncol. 1994;52(1):94-8.

Feng D, Chen H, Yang KX, Fang F. Pre-peritoneal lipoleiomyoma with hyperoestrogenism in a postmenopausal woman. J Obstet Gynaecol. 2011;31(6):556-7.

Oh MH, Cho IC, Kang YI, Kim CY, Kim DS, Cho HD, et al. A case of retroperitoneal lipoleiomyoma. J Korean Med Sci. 2001;16(2):250-2.

Lin KC, Sheu BC, Huang SC. Lipoleiomyoma of the uterus. Int J Gynaecol Obstet. 1999;67(1):47-9.

Kitajima K, Kaji Y, Imanaka K, Sugihara R, Sugimura K. MRI findings of uterine lipoleiomyoma correlated with pathologic findings. AJR Am J Roentgenol. 2007;189(2):W100-4.

Tyagi N, Tyagi R, Griffin Y. Uterine lipoleiomyoma. BMJ Case Rep. 2014;2014:2014207763.

Ghosh B, McKeown B, Gumma A. Lipoleiomyoma. BMJ Case Rep. 2011;2011:bcr0820114577.

Arikawa S, Uchida M, Shinagawa M, Tohnan T, Hayabuchi N. Significance of the " beak sign"in the differential diagnosis of uterine lipoleiomyoma from ovarian dermoid cyst. Kurume Med J. 2006;53(1-2):37-40.

Mishra SS, Saha A, Mishra P, Jena SK. Lipoleiomyoma of the left broad ligament with dermoid cyst in ipsilateral ovary and synchronous multiple benign lesions of female genital tract: An unusual association. Indian J Pathol Microbiol. 2016;59(3):355-8.

Drylewicz MR, Lubner MG, Pickhardt PJ, Menias CO, Mellnick VM. Fatty masses of the abdomen and pelvis and their complications. Abdom Radiol (NY). 2019;44(4):1535-53.

Ravikanth R, Kamalasekar K. A Rare Presentation of Cervical Lipoleiomyoma with Hematometra. Gynecol Minim Invasive Ther. 2020;9(1):49-50.

Aizenstein R, Wilbur AC, Aizenstein S. CT and MRI of uterine lipoleiomyoma. Gynecol Oncol. 1991;40(3):274-6.

Chu CY, Tang YK, Chan TS, Wan YH, Fung KH. Diagnostic challenge of lipomatous uterine tumors in three patients. World J Radiol. 2012;4(2):58-62.

Erdem G, Celik O, Karakas HM, Alkan A, Hascalik S. Pure uterine lipoma. Magn Reson Imaging. 2007;25(8):1232-6.

Ando T, Kato H, Furui T, Morishige KI, Goshima S, Matsuo M. Uterine smooth muscle tumours with hyperintense area on T1 weighted images: differentiation between leiomyosarcomas and leiomyomas. Br J Radiol. 2018;91(1084):20170767.

Bolan C, Caserta MP. MR imaging of atypical fibroids. Abdom Radiol (NY). 2016;41(12):2332-49.

Gaskin CM, Helms CA. Lipomas, lipoma variants, and well-differentiated liposarcomas (atypical lipomas): results of MRI evaluations of 126 consecutive fatty masses. AJR Am J Roentgenol. 2004;182(3):733-9.

Bajaj P, Kumar G, Agarwal K. Lipoleiomyoma of broad ligament: a case report. Indian J Pathol Microbiol. 2000;43(4):457-8.

Aung T, Goto M, Nomoto M, Kitajima S, Douchi T, Yoshinaga M, et al. Uterine lipoleiomyoma: a histopathological review of 17 cases. Pathol Int. 2004;54(10):751-8.

Feng D, Chen H, Yang KX, Fang F. Pre-peritoneal lipoleiomyoma with hyperoestrogenism in a postmenopausal woman. J Obstet Gynaecol. 2011;31(6):556-7.

Uner A, Tiras MB, Kilic D, Dursun A, Dilek U. Uterine lipoleiomyoma containing metastatic breast carcinoma: a case with two unusual pathologies. Eur J Obstet Gynecol Reprod Biol. 2003;106(1):76-8.

Vilos GA, Allaire C, Laberge PY, Leyland N. The management of uterine leiomyomas. J Obstet Gynaecol Can. 2015;37(2):157-78.

López FR, Ornat L, Ceausu I, Depypere H, Erel CT, Lambrinoudaki I, et al. EMAS position statement: management of uterine fibroids. Maturitas. 2014;79(1):106-16.

Jagtap SV, Phalke A, Kshirsagar NS, Jagtap SS, Nasre N. Uterine Lipoleiomyoma: a rare variant of benign uterine neoplasm. Int J Reprod Contracept Obstet Gynecol 2019;8:2553-5.

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Published

2022-09-27

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Section

Case Reports