Uncommon Presentation of a Uterine Lipoleiomyoma

Background: Uterine lipoleiomyomas are rare benign tumors, which preferentially occur in postmenopausal women between the ages of 45 and 70 years. Histologically, these tumors consist of fully differentiated smooth muscle cells and adipocytes. Case: The unusual clinical presentation of a uterine lipoleiomyoma, which was first suspected to be a tumor of adnexal origin (e.g., a dermoid) is presented. However, subsequent magnetic resonance imaging (MRI) investigation revealed a uterine tumor with predominantly fatty appearance. Histologic examination after laparoscopically assisted total hysterectomy showed a benign lipoleiomyoma of the uterine corpus. Conclusions: Because of their fatty components, lipoleiomyomas can be sonographically misdiagnosed as cystic lesions. MRI can reveal the characteristic features of a fatty tumor, and complete surgical removal is required to exclude other malignant tumors with fatty components, such as sarcomas. (J GYNECOL SURG 27:163)