Lipoleiomyoma

Lipoleiomyoma is an exceedingly rare benign uterine tumor which has been reported infrequently in the medical literature. The tumor is generally found in postmenopausal women, in any region of the uterus and may be asymptomatic or may cause pelvic pain or abnormal bleeding. Commonest location is uterine fundus. Despite its rarity, the imaging characteristics of lipoleiomyoma provided by the tumor’s mixture of fat, smooth muscle and fibrous tissue afford the radiologist the opportunity to make a specific diagnosis. It can be differentiated from lipoma only on histopathology. Lipomas do not have smooth muscles within them. On Gray-scale sonography, lipoleiomyoma is a discrete, well-defined heterogeneous mass within the myometrium, sometimes exophytic, which is hyperechoic due to the presence of fat [1] Similarly, on CT images the tumor shows typical areas of fat attenuation within a circumscribed uterine mass. MR imaging reveals a well-circumscribed heterogeneous mass with high signal intensity on T1 weighted sequences, and low signal intensity on fat-saturated or T2 weighted images. Chemical shift artifact also confirms the fat content of the tumor [2]. Differential diagnosis includes degenerative uterine leiomyoma and cystic ovarian teratoma. Thus a clear distinction must be made between the observed uterine finding and adnexal structures; and fat content, rather than areas of hemorrhagic degeneration, must be clearly demonstrated. Because of the benign nature of lipoleiomyoma, unnecessary surgery may be spared in an asymptomatic individual.