Pure Uterine Lipoma: A Report of a Rare Entity

Abstract

Abnormal genital tract bleeding is a commonly encountered complaint in general practice. It has a wide range of etiologies and the spectrum depends on the reproductive status of the patient. While it represents a small proportion of genital tract bleeding, endometrial carcinoma is the main concern in postmenopausal women with abnormal genital bleeding. However, the majority of cases are due to benign etiologies. We present the case of a 65-year-old woman who presented to the outpatient department complaining of vaginal bleeding and lower abdominal pain for the last two months. The patient did not report any use of hormonal replacement therapy. Her last Pap smear was five years ago and it yielded no abnormal cells. On examination, the patient appeared obese with a body mass index of 35 kg/m 2 . Abdominal examination revealed a palpable pelvic mass that was firm and non-tender. The patient underwent an abdominal computed tomography scan which demonstrated a well-defined oval-shaped homogeneous fat attenuation mass lesion within the uterine wall with no evidence of invasion. Such findings were suggestive of uterine lipoma. The patient underwent a total hysterectomy and bilateral salpingo-oophorectomy. Histopathological examination of the specimen confirmed the diagnosis of pure lipoma. After six months of close follow-up, the patient had no active complaints. Pure uterine lipoma is an exceedingly rare benign neoplasm of the uterus. It may present with an abdominal mass and abnormal genital bleeding. Awareness of the clinical and radiological features of this tumor is crucial to avoid unnecessary surgeries in asymptomatic patients.

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

“…Pure malignant or benign lipomatous tumors (liposarcomas or lipomas) or other rare mesenchymal tumors with occasional foci of adipocytic differentiation (such as solitary fibrous tumors) also enter the differential diagnosis with LLMs; they are usually reported in the uterine body, exceptionally occurring in the cervix [14,[45][46][47][48][49][50][51][52]. Lipomas are entirely composed of fat tissue, while liposarcomas show malignant histological features that were absent in our series.…”

“…Lipomas are entirely composed of fat tissue, while liposarcomas show malignant histological features that were absent in our series. Solitary fibrous tumors have a haphazard arrangement of spindled to ovoid cells arranged around branching and dilated vasculature within a variably collagenous stroma; desmin is expressed by a subset of cases while STAT6 positivity is typical [14,[45][46][47][48][49][50][51][52].…”

A giant colonic lipoma

“…They are the most common benign soft tissue tumour in adults 1 . Most commonly found subcutaneously on the trunk and limbs, they can also be located in the gastrointestinal tract and rarer locations such as intracerebrally and in the genitourinary tract 2,3 …”

“…1 Most commonly found subcutaneously on the trunk and limbs, they can also be located in the gastrointestinal tract and rarer locations such as intracerebrally and in the genitourinary tract. 2,3 Colonic lipomas are often small, asymptomatic and incidentally found on routine colonoscopy. If small and asymptomatic, they can be left in situ.…”

“…8 Giant lipomas can measure up to over 20 cm and have been previously described as a cause of colo-colonic intussusception in case studies. 3 Case series are rare and most are limited to a few patients. 9 The largest case series was 21 lipomas in 17 patients published by Rogy et al in 1991.…”