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Clinical and Pathological Features of Lipoleiomyoma of the Uterine Corpus: A Review of 76 Cases
Lipoleiomyoma is a rare and easily recognized benign variant of uterine leiomyoma, composed of an intimate admixture of mature smooth muscle cells and adipocytes, often with the former element predominant, most commonly found in the uterine corpus (1-4).In 1916, Lopstein first described a lipoleiomyoma, but this received little attention in the literature (5). Its lack of specific histological features led researchers to underestimate its occurrence rate. The largest reports in the literature belong to Wang et al. (1) with 50 cases and Aung et al. (2) with 17 cases. To this day, there is no uniform accepted classification and the histogenesis is not resolved. Willen and Pounder (5, 6) designated these tumors as "uterine fatty tumors" and subdivided them into "lipoma" and "mixed lipoma/leiomyoma" (lipoleiomyoma). Modern research rejects the view that these tumors are hamartomas, choristomas, fatty metamorphosis, or lipomatous degeneration. They probably represent tumor metaplasia within a leiomyoma. However, some studies show monoclonality (7), and lipoleiomyoma is now regarded as a distinctive true neoplasm (8). Therefore, its pathogenesis and clinical significance remain to be clarified. Regardless of its origin, lipoleiomyomas have been consistently considered benign.Our study aimed to investigate the clinical, pathological and immunohistochemical features of uterine lipoleiomyoma and to confirm the benign nature of these tumors. MATERIAL AND METHODSThis is a retrospective study of 70 patients who had undergone hysterectomy and myomectomy over a 13-year period Background: Uterine lipoleiomyoma is a rare and specific type of leiomyoma with a considerable amount of adipocytes. Aims: The aim of the study was to investigate the clinical, pathological and immunohistochemical features of lipoleiomyoma of the uterine corpus, and review its histogenesis and differential diagnosis from other neoplastic and non-neoplastic lesions in order to obtain a detailed profile of this somewhat uncommon lesion. Study Design: Descriptive study. Methods: This study is a retrospective analysis of 70 consecutive women with 76 lipoleiomyomas, who underwent surgery mainly for uterine leiomyoma and gynecological carcinomas between January 2000 and April 2013. Clinical and pathological information was obtained from medical records. Immunohistochemistry was applied in selected cases. Parametric methods were used to compare clinical and pathologic features. Results: The patients ranged in age from 34 to 77 years (mean 55.49 years). Lipoleiomyomas ranged from 0.5 to 55 cm in diameter (mean 5.50 cm). Typical macroscopic and microscopic features were noted.Sixty-nine (90.7%) tumors were in the uterine corpus and five (6.5%) were in the cervix. One broad ligament tumor and one retroperitoneal tumor were also studied. No tumors displayed cytologic atypia, mitosis, necrosis, calcification, or other degenerative changes. Immunohistochemically, the adipose tissue element was positive for vimentin, desmin, S100 protein, estrogen (ER), progesterone (...
Clinical and Pathological Features of Lipoleiomyoma of the Uterine Corpus: A Review of 76 Cases
Lipoleiomyoma is a rare and easily recognized benign variant of uterine leiomyoma, composed of an intimate admixture of mature smooth muscle cells and adipocytes, often with the former element predominant, most commonly found in the uterine corpus (1-4).In 1916, Lopstein first described a lipoleiomyoma, but this received little attention in the literature (5). Its lack of specific histological features led researchers to underestimate its occurrence rate. The largest reports in the literature belong to Wang et al. (1) with 50 cases and Aung et al. (2) with 17 cases. To this day, there is no uniform accepted classification and the histogenesis is not resolved. Willen and Pounder (5, 6) designated these tumors as "uterine fatty tumors" and subdivided them into "lipoma" and "mixed lipoma/leiomyoma" (lipoleiomyoma). Modern research rejects the view that these tumors are hamartomas, choristomas, fatty metamorphosis, or lipomatous degeneration. They probably represent tumor metaplasia within a leiomyoma. However, some studies show monoclonality (7), and lipoleiomyoma is now regarded as a distinctive true neoplasm (8). Therefore, its pathogenesis and clinical significance remain to be clarified. Regardless of its origin, lipoleiomyomas have been consistently considered benign.Our study aimed to investigate the clinical, pathological and immunohistochemical features of uterine lipoleiomyoma and to confirm the benign nature of these tumors. MATERIAL AND METHODSThis is a retrospective study of 70 patients who had undergone hysterectomy and myomectomy over a 13-year period Background: Uterine lipoleiomyoma is a rare and specific type of leiomyoma with a considerable amount of adipocytes. Aims: The aim of the study was to investigate the clinical, pathological and immunohistochemical features of lipoleiomyoma of the uterine corpus, and review its histogenesis and differential diagnosis from other neoplastic and non-neoplastic lesions in order to obtain a detailed profile of this somewhat uncommon lesion. Study Design: Descriptive study. Methods: This study is a retrospective analysis of 70 consecutive women with 76 lipoleiomyomas, who underwent surgery mainly for uterine leiomyoma and gynecological carcinomas between January 2000 and April 2013. Clinical and pathological information was obtained from medical records. Immunohistochemistry was applied in selected cases. Parametric methods were used to compare clinical and pathologic features. Results: The patients ranged in age from 34 to 77 years (mean 55.49 years). Lipoleiomyomas ranged from 0.5 to 55 cm in diameter (mean 5.50 cm). Typical macroscopic and microscopic features were noted.Sixty-nine (90.7%) tumors were in the uterine corpus and five (6.5%) were in the cervix. One broad ligament tumor and one retroperitoneal tumor were also studied. No tumors displayed cytologic atypia, mitosis, necrosis, calcification, or other degenerative changes. Immunohistochemically, the adipose tissue element was positive for vimentin, desmin, S100 protein, estrogen (ER), progesterone (...
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