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Year : 2010  |  Volume : 53  |  Issue : 4  |  Page : 840-841
Lipoleiomyoma of uterus: A case report with review of literature


Department of Pathology, Dr. D. Y. Patil Medical College, Mumbai, India

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Date of Web Publication27-Oct-2010
 

How to cite this article:
Sudhamani S, Agrawal D, Pandit A, Kiri V M. Lipoleiomyoma of uterus: A case report with review of literature. Indian J Pathol Microbiol 2010;53:840-1

How to cite this URL:
Sudhamani S, Agrawal D, Pandit A, Kiri V M. Lipoleiomyoma of uterus: A case report with review of literature. Indian J Pathol Microbiol [serial online] 2010 [cited 2020 Nov 26];53:840-1. Available from: https://www.ijpmonline.org/text.asp?2010/53/4/840/72075


In spite of relatively common occurrence of leiomyomas of uterus, lipoleiomyomas are rare variants of uterine leiomyoma. The incidence is variously reported as 0.03-0.2%. [1] It has to be distinguished from pure lipoma of uterus which is very rare. In this report, we seek to discuss one such case and review literature of this distinct lesion.

A 58-year-old postmenopausal woman presented with history of something coming out of vagina for 4 months and white discharge per vagina. On examination, there was grade II uterovaginal prolapse with cystocele and rectocele. Cervix revealed procidential changes. On ultrasonography, there were multiple leiomyomas of uterus, the largest measuring 4 × 3 × 2 cm. Vaginal hysterectomy was done and uterus with cervix was received for histopathological examination.

On gross examination, external surface of uterus showed a single subserosal leiomyoma of 1 cm in diameter. Cut section of uterus showed one submucosal leiomyoma of 4 × 4 × 2.5 cm; the cut surface was gray white with yellow areas. Also, there was an intramural leiomyoma measuring 3 × 3 × 2 cm; cut surface of both subserosal and intramural masses were gray white with whorled appearence. Paraffin embedded sections were prepared from all these tumors and stained with hematoxylin and eosin. Microscopically, the sections from the submucosal mass displayed a tumor showing benign smooth muscle cells intermingled between lobules of mature adipocytes [Figure 1], [Figure 2], [Figure 3]. Other tumors showed features of typical leiomyoma. Sections from endometruim showed cystic atrophy. Cervix was unremarkable.
Figure 1: Mature adipocytes within leiomyoma (H and E, ×100)

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Figure 2: Adipocytes intermingled with smooth muscle cells (H and E, ×100)

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Figure 3: Mature adipocytes and benign smooth muscle cells (H and E, ×400)

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   Discussion Top


Uterine leiomyomas are extremely common neoplasms with a quoted incidence of 4-11% and mainly seen (40%) in women over 50 years. [2] Many variants which are the result of secondary changes have been described and are detec table in around 65% of cases. Lipoleiomyoma is an alteration that was previously called as fatty metamorphosis, lipomatous degeneration, adipose metaplasia, etc. It is now regarded as a distinct true neoplasm.

It is prevalent in peri-menopausal women, often associated with multiple leiomyomas with a preference in sub-serosa. Pathogenesis has been variously ascribed to as mixed, benign, heterologous or mesenchymal neoplasm. [3] The lesion is benign and the only puzzle for the pathologist could be the unexpected presence of fat in a uterine tumor. [4] Diagnosis of pure lipoma is made when any smooth muscle, if present, is confined to periphery of the tumor.

Most of them are postoperative chance findings and the diagnosis is made in retrospect. It is often diagnosed preoperatively as leiomyoma or ovarian mature teratomas. Computed tomography (CT) and magnetic resonance imaging (MRI) can assist in the preoperative diagnosis of these lesions.

 
   References Top

1.Bajaj P, Kumar G, Agarwal K. Lipoleimyoma of broad ligament: A case report. Indian J Pathol Microbiol 2000;43:457-8.  Back to cited text no. 1
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2.Fernandes H, Naik CN, Swethadri GK, Bangera I, Miranda D. Pure lipoma of the Uterus: A rare case report. Indian J Pathol Microbiol 2007;50:800-1.  Back to cited text no. 2
[PUBMED]    
3.Dey P, Dhar KK. Lipomatous tumour of uterus. J Indian Med Assoc 1993;91:99.  Back to cited text no. 3
[PUBMED]    
4.Hendrikson MR, longacre AT, Kempson RL. The uterine corpus. In: Mills SE, editor. Sternberg's Diagnostic Surgical Pathology. 4 th ed. Philadelphia: Lippincott Williams and Wilkins; 2004. p. 2519.  Back to cited text no. 4
    

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Correspondence Address:
Durgaprasad Agrawal
Department of Pathology, Dr. D. Y. Patil Medical College, sect-5, Nerul, Navi Mumbai - 400 706
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0377-4929.72075

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    Figures

  [Figure 1], [Figure 2], [Figure 3]

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