A case report of pelviscopic resection of lipoleiomyoma originating from the uterine cervix in a postmenopausal woman

Kim, Yun Sook; Lee, Ji Hye

doi:10.1097/md.0000000000030665

Cited by 4 publications

(22 citation statements)

References 14 publications

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“…Lipo-leiomyoma belongs to a spectrum of primary uterine lipomatous tumours that includes pure lipomas, angioleiomyoma, fibromyolipoma, and liposarcoma (1). It is an extremely rare benign tumour of the uterus seen in perimenopausal women (2,4,5). However, it can be seen in atypical sites like the retro peritoneum, cervix, broad ligament, abdominal cavity, and ovaries (5,8).…”

Section: Discussionmentioning

confidence: 99%

“…It is an extremely rare benign tumour of the uterus seen in perimenopausal women (2,4,5). However, it can be seen in atypical sites like the retro peritoneum, cervix, broad ligament, abdominal cavity, and ovaries (5,8). Mostly asymptomatic, lipo-leiomyoma does not have unique symptomatology.…”

Section: Discussionmentioning

confidence: 99%

“…Lipo-leiomyoma is extremely unwonted, accounting for only about 0.03%-0.2% of uterine tumours (4). Lipo-leiomyomas predominantly occur in the uterus, but extra-uterine tumours in the retroperitoneum, ovaries, and abdominal cavity have been described (1,5). They occur commonly in perimenopausal and postmenopausal women in their sixth and seventh decades (5).…”

Section: Introductionmentioning

confidence: 99%

“…Lipo-leiomyomas predominantly occur in the uterus, but extra-uterine tumours in the retroperitoneum, ovaries, and abdominal cavity have been described (1,5). They occur commonly in perimenopausal and postmenopausal women in their sixth and seventh decades (5). Uterine lipo-leiomyoma is similar to uterine leiomyoma in presentation and clinical course.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, lipo-leiomyoma, if asymptomatic, requires no treatment. In symptomatic patients, surgical resection is done to differentiate it from other tumours and where the diagnosis is in doubt (4,5).…”

Section: Introductionmentioning

confidence: 99%

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A rare case of uterine lipo-leiomyoma in a 63-year-old Nigerian woman; a case report

Solaja,

Nwadiokwu,

Okebalama

et al. 2023

Babcock Univ. Med. J.

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Background: Lipo-leiomyoma accounts for about 0.03%-0.2% of uterine tumours. The aetiology of lipo-leiomyoma is unclear, with some suggesting fatty metamorphogenesis and others involving growth factors and oestrogens. Radiological evaluation and histology are necessary for definitive diagnosis. If asymptomatic, no treatment is needed, but surgical resection is performed in symptomatic patients. Case Presentation: This was a case of a 63-year-old Nigerian woman who experienced pelvic pain and heaviness for a year, worsening pelvic pain and distension, and post-menopausal bleeding. Abdominal examinations revealed a pelvic mass, vaginal examination showed no vaginal and cervical lesions, while abdominopelvic ultrasonography (USS) unveiled a hyperechoic mass in the posterior uterus. She underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy. Histopathological assessment of the samples showed a confirmatory diagnosis of uterine lipo-leiomyoma. Conclusion: Lipo-leiomyoma is a rare, distinct uterine pathology that should be considered a differential diagnosis in post-menopausal women with vaginal bleeding. Total abdominal hysterectomy and bilateral salpingo-oophorectomy are recommended for menopausal women with symptomatic disease to prevent recurrent anaemia and also remove possible sites of the tumour even as the patient is unlikely to conceive again. Histopathological evaluation is crucial for post-menopausal women with coexisting bleeding per vagina.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

A rare case of uterine lipo-leiomyoma in a 63-year-old Nigerian woman; a case report

Solaja,

Nwadiokwu,

Okebalama

et al. 2023

Babcock Univ. Med. J.

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Lipoleiomyoma of the uterus in a woman of reproductive age (clinical case)

Talash,

Palyokha,

Gromova

et al. 2024

Medicni Perspektivi

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Uterine lipoleiomyoma is one of the variants of uterine leiomyoma, which is histologically represented by the presence of mature fat and smooth muscle cells. The relevance of the coverage of this clinical case is determined by the extreme rarity of the development of uterine lipoleiomyoma in women of reproductive age. The purpose of this work was to record this clinical case in the world statistics of lipoleiomyoma, to evaluate methods of diagnosis and differential diagnosis, to determine the role of early diagnosis of uterine lipoleioma in the subsequent tactics and scope of surgical treatment. Data from the medical records of a 41-year-old inpatient were analyzed. In addition to the generally accepted clinical and biochemical methods of blood and urine examination, electrocardiogram, ultrasound examination of the pelvic organs, the level of ovarian tumor markers in the blood (CA 125, HE4 and the ROMA index) was determined. The diagnosis of the disease was based on the data of pathohistological and immunohistochemical studies. Based on the results of a review of the medical literature, analysis of articles obtained as a result of a search of PubMed, SCOPUS, Web of Science, MedScape databases, the current state of the problem is highlighted, literary data related to the incidence, features of the clinical course, diagnosis and treatment of uterine lipoleiomyoma are summarized. The clinical case presented in the article demonstrates an incidental finding of a uterine lipoleiomyoma in a woman of reproductive age, measuring 30x25x20 cm, originated subserously from the body and cervix of the uterus, in the area of its isthmus. Under this condition, it occupied the entire Douglas space, the area of the sacro-uterine ligaments and the parietal peritoneum, intimately adjacent to the sigmoid and rectum, to the ureters and iliac vessels. The peculiarity of this clinical case is that sonographically uterine lipoleiomyoma was hidden under the "mask" of a dermoid cyst of the right ovary. Macroscopically, it differed from a typical lipoleiomyoma by the purple-bluish color of its outer surface and soot-colored, fine-lobed spongy structure on the section. The diagnosis of uterine lipoleiomyoma was verified only on the basis of pathohistological and immunohistochemical research. Microscopically, the lipoleiomyoma had a mesenchymal structure with a pronounced vascular component and consisted of mitotically inactive bundles of smooth muscle cells and mature adipocytes. Immunohistochemically, a positive reaction for caldesmon, desmin, smooth muscle actin alpha of tumor cells and for S.100 (DAKO, polyclonal) fatty cells was detected, which confirmed the hypothesis of direct transformation of smooth muscle cells existing in the leiomyoma of the uterus into fatty cells. This clinical case should complement the global statistical indicators of diagnosis of uterine lipoleiomyoma in women of reproductive age. Lipoleiomyoma should be considered as the primary diagnosis in case of detection of a large uterine tumor in women with excess body weight and be removed immediately after diagnosis, otherwise it is impossible to exclude its malignancy. For the planned diagnosis of neoplasms of the female genital organs, preference should be given to non-invasive research methods: magnetic resonance or computer tomography with contrast enhancement. The problem of these tumors lies in their unpredictable histogenesis, the unexpected presence of fat in the microscopic structure, and in the visual similarity to sarcomas. Verification of the diagnosis is carried out on the basis of pathohistological and immunohistochemical studies of the tumor preparation. Uterine lipoleioma can have a purplie-bluish color and develop by a broad base from the body and cervix of the uterus, as a result of "lipomatous" metaplasia of the uterine leiomyoma existing in a woman. Regular preventive examinations of women of all ages are crucial for timely detection of this rare neoplasm.

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Lipoleiomyomas of the Uterine Cervix: A New Series including the First Recurrent Case and the First Systematic Literature Review

Palicelli

Ardighieri

Broggi

et al. 2022

JPM

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Uterine leiomyomas usually arise from the uterine body (95%), and rarely from the cervix (0.6%) or other urogenital sites. Lipoleiomyomas are benign, uncommon variants of leiomyomas (0.03–0.2%), histologically composed of smooth muscle cells and mature adipocytes; they usually occur in the uterine body and exceptionally in the cervix. We performed the first systematic literature review of cervical lipoleiomyomas (PRISMA guidelines), presenting five new cases. Including our series, thirty-one detailed cases were reported in the literature (mainly in Asia). The age range was 35–74 years, revealing a higher mean age than conventional cervical leiomyomas (46.5 vs. 39.4 years). Patients were usually multiparous (94%), typically complaining of vaginal bleeding (11/31, 36%), pelvic/abdominal pain (10/31, 32%), and/or urinary disturbances (6/31, 19%) 1 week to 10 months before presentation. Clinical examination revealed a pedunculated tumor (48%), or prolapse of ≥1 pelvic organs (16%). Twenty-four (77%) patients underwent total hysterectomy ± additional surgery; simple myomectomy/excision was performed in five (16%) cases. Only one (3%) of our cases recurred 2 years after partial excision; no evidence of disease was found 13 years after recurrence excision. Adipocytes occupied ≤50% of the tumor volume. Hyaline or myxoid changes and cartilaginous metaplasia were uncommon histological findings. Surgically challenging cases or pregnant patients may require expert gynecologists. Interventional radiology or conservative treatments were rarely proposed.

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A case report of pelviscopic resection of lipoleiomyoma originating from the uterine cervix in a postmenopausal woman

Cited by 4 publications

References 14 publications

A rare case of uterine lipo-leiomyoma in a 63-year-old Nigerian woman; a case report

A rare case of uterine lipo-leiomyoma in a 63-year-old Nigerian woman; a case report

Lipoleiomyoma of the uterus in a woman of reproductive age (clinical case)

Lipoleiomyomas of the Uterine Cervix: A New Series including the First Recurrent Case and the First Systematic Literature Review

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