MRI Findings of Uterine Lipoleiomyoma Correlated with Pathologic Findings

Abstract

Uterine lipoleiomyoma typically presents as a well-demarcated mass showing hyperintensity with hypointense amorphous bundles on T1- and T2-weighted images with chemical shift artifacts. The hyperintense region suppressed on chemical shift fat-suppressed sequences and the hypointense bundles enhanced by contrast material pathologically correspond to mature fat tissue and smooth muscle tissue, respectively. Even in an atypical case with a small volume of fat tissue in the mass, a fat-suppression MRI sequence is especially useful for the diagnosis.

Lipoleiomyoma: a case report

“…8 The differential diagnoses of similar uterine tumours with adipose tissue include spindle cell lipoma, angiolipoma, angiomyolipoma, leiomyoma with fatty degeneration, atypical lipoma, and well differentiated liposarcoma. 4,5 The histological structure and immunohistochemical profile suggest that the lipoleiomyomas probably result from a metaplasia of the smooth muscle cells more than a true neoplastic process.…”

“…Fat saturation technique is used to confirm the diagnosis of lipoleiomyoma. 8 The lesion appears suppressed on fat saturation images.…”

A Case Report and Review of the Literature on Uterine Fatty Tumours (UFT): A Field of Heterogeneous Data

“…When clinical manifestations such as sudden lump enlargement or pelvic masses are present, the implementation with CT and MR becomes mandatory. Despite the very high specificity of MR for detecting origin and mass constitution (fat tissue), the diagnosis is made only after excluding other pelvic masses (benign cystic ovarian teratoma, malignant degeneration of cystic teratoma, lipomatous ovarian tumour, pelvic lipoma, liposarcoma and lipoblastic lymphadenopathy) [9,10,20,21]. CT and MR have allowed valid follow up of pelvic masses in one patient with severe medical contraindication to surgery [7] but pitfalls in imaging interpretation may always happen and one case with fatal consequences due to unnecessary surgery (lipoleiomyoma misdiagnosed as liposarcoma -patient died post hysterectomy) has been reported [22].…”

“…Little or nothing about UFT is found in important gynaecological journals. Moreover it is not clear which diagnostic tool among ultrasound, CT and MR should be best utilized for clinical follow up of these nodules [7,8], whether hysterectomy should or not always warranted [9,10] and how frequently a malignant transformation of these tumours should also be expected [3,11]. We report here a single case of UFT along with a full literature review on this topic with the aim to help gynaecologists in the clinical counselling of these tumours.…”

Uterine lipoleiomyoma: A case report and literature review

“…It reveals a heterogeneous mass with high signal intensity on T1-weighted images in the lesion [6]. Although, it is not often possible to differentiate uterine LL with other lipomatous tumours [12].…”