Histopathology:
- Uterine mass shows the mixture of mature adipocytes and long intersecting bundles of bland, spindle-shaped smooth muscle cells. Focal hyalinised stroma is also seen.
- Cytologic atypia is not seen in spindle cells and adipose tissue components.
Practical points of Pathoclinics:
- Uterine lipoleiomyoma is an uncommon but easily recognized variant of leiomyoma, occurring primarily in obese perimenopausal and post-menopausal patients.
- Clinical presentation is non-specific and like that of routine leiomyomas.
- Radiology imaging plays an important role in preoperative diagnosis and localization of lipoleiomyoma.
- Any site of the uterus can be involved in lipoleiomyoma. Lipoleiomyomas are of variable size nodular well-circumscribed masses, with pale to yellow cut surface, depending on the fat content.
- Uterine lipoleiomyoma has a variable (minimal to marked) amount of mature adipose tissue. Few lipoleiomyoma can have infiltration of lymphocytes.
- Cytologic atypia, mitosis, necrosis, calcification, degenerative changes, or lipoblasts are NOT seen in uterine lipoleiomyomas.
- Significant number (approximately 75%) of lipoleiomyomas associated with hyperestrogenic status, such as adenomyosis, endometriosis, endometrial hyperplasia, and polyps, complex atypical endometrial hyperplasia, and gynecologic carcinomas (endometrial, ovarian, and breast malignancy). Therefore, the findings of lipoleiomyoma alert the gynecologist to look for coexistent gynecologic neoplasm.
- Lipoleiomyomas may also be associated with hyperlipidemia, hypothyroidism, and diabetes mellitus.
- Very rarely sarcomas can arise from uterine lipoleiomyomas.
- In cases of uterine serosal or broad ligament lipoleiomyoma, adequate gross evaluation and sectioning is necessary to rule out teratomatous ovarian neoplasm.
References:
- Manjunatha HK, Ramaswamy AS, Kumar BS, Kumar SP, Krishna L. Lipoleiomyoma of uterus in a postmenopausal woman. J Midlife Health. 2010 Jul;1(2):86-8. doi: 10.4103/0976-7800.76219. PMID: 21716761; PMCID: PMC3122497.
- 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 Sep;31(3):224-9. doi: 10.5152/balkanmedj.2014.13079. Epub 2014 Sep 1. PMID: 25625021; PMCID: PMC4299967.