Uterine Lipoleiomyoma in Peri or Postmenopausal Women

Abstract

Lipoleiomyoma is an uncommon neoplasm of the uterus, composed of smooth muscles intermixed with mature adipocytes. These tumors are considered a benign variant of uterine leiomyomas. Herein, we report six cases of lipoleiomyoma experienced in our institution from January 2005 to March 2015. The patients ranged in age from 45 to 70 years; the etiology may be related to estrogen deficiency occurring after menopausal transition. Except for one lipoleiomyoma in the broad ligament, all others were found in the uterine corpus. The presenting symptoms were nonspecific, and most cases were incidentally diagnosed during surgery for other reasons. We performed preoperative imaging studies, including abdominal and pelvic computed tomography and magnetic resonance imaging. Preoperatively, four patients were diagnosed as having a pelvic mass and one patient was diagnosed as having a right ovarian mature teratoma. In one case, we found a gynecologic malignancy (cervical cancer 1A1). Histologically, there was no gross or microscopic contiguity between the lipoleiomyoma and the malignancy. Lipoleiomyomas seem to have a benign clinical course. In our study, there were no recurrences of or deaths attributed to the lipoleiomyomas during a mean follow-up period of 16.17 ± 23.80 months.

A six-year study of leiomyomata with emphasis on lipoleiomyoma

“…13 Oh SR et al, studied a total of six lipoleiomyomas of which five occurred in uterine corpus and one in broad ligament. 11 Among the uterine lipoleiomyomas, we noted intramural as the most common site of occurrence which was similar to the study by Sharma et al, and Abraham et al (Table 3). 3,14 The amount of adipose tissue in the lipoleiomyoma varies from 5%-95% of the tumor mass in the study by Bolat et al 4 In present study, amount of adipose tissue varied from 10%-60% of the tumor mass.…”

“…9 Kelecki et al, and Oh SR et al, noted that lipoleiomyomas were seen in postmenopausal group. 10,11 However, in present study, the age group ranged from 32-55years, of these five were premenopausal and three were postmenopausal.…”

Significance of postmenopausal uterine leiomyomas: Focus on variants

“…These reports suggest that lipoleiomyomas are relatively common leiomyoma variants among postmenopausal women requiring surgical treatment. The incidence of lipoleiomyomas was 0.35–2.9% of leiomyomas and 0.28–2.1% of patients . In the current study, the incidence of lipoleiomyomas among leiomyoma patients was 2.3% (11/471).…”

“…On the other hand, a case was reported in which the levels of cytosolic estrogen and progesterone receptors were lower in the lipoleiomyoma than in the myometrium; decreased steroid receptors was speculated to be responsible for the lipomatous neometaplasia in this tumor . It was also reported that the etiology of lipoleiomyomas may be related to the estrogen deficiency that occurs after the menopausal transition . ln our study, one patient with lipoleiomyomas had a history of breast cancer (9.1%).…”

Uterine lipoleiomyoma: A case report and literature review

“…Theses tumors are histologically composed of variable amounts of smooth muscle, fat cells, and fibrous tissue. LL is considered as a benign variant of leiomyoma predominantly located in intramural uterine fundus [2][3][4]. The incidence of this neoplasm varies from 0.03% to 0.2% [2,5,6].…”