Uterine lipoleiomyoma
Updates to Article Attributes
Uterine lipoleiomyomas results result from the degeneration of smooth muscle cells ofin an ordinary leiomyoma and represent a rare benign tumour of the uterus1.
Epidemiology
Lipoleiomyomas have a reported incidence of 0.03-0.2% and are typically found in post-menopausal patients with typical uterine leiomyomas 2.
Clinical presentation
Although most patients are asymptomatic, they can present with symptoms similar to leiomyomas of the same size and location. Symptoms include but are not limited to abdominal / pelvic pain, palpable mass and menstrual abnormalities.
Pathology
Many considered a uterine lipoleiomyoma as a distinct variety of leiomyoma. Histologically, it is composed of variable amounts of adipocytes and smooth muscle cells separated by thin fibrous tissue. The exact aetiology is not well known ; but is mostly thought tp represent fatty metamorphosis of the smooth muscle cells of a leiomyoma. Lesions can vary in size from a few mm to a few cm's.
Radiographic features
Advanced imaging of these lesions allow for differentiation from cystic ovarian neoplasms, which may require surgical therapy 3.
Pelvic ultrasound
Lesions are typically hyper-echoic with a partially hypoechoic rim. This rim likely represents the layer of myometrium surrounding the fatty central component 3. There is often poor vascularity seen on colour doppler examination
CT
Often seen as a predominantly fat containing well demarcated mass with areas of soft tissue density arising from uterus 3.
Pelvic MRI
Secondary to the predominant fatty component in the lesion, hyperintensity is seen on T1 weighted sequences and chemical shift artifacts are noted. Additionally, fat suppression techniques can be useful in verifying the diagnosis - most of the lesion shows fat suppression 3. Signal characteristics are therefore
-
T1:
- highhigh signal -
T1 FS:
- lowlow signal -
T2
-: high signal -
T2 FS/STIR
-: low signal
Treatment and prognosis
Treatment is similar to leiomyomas and is dependent on the clinical symptoms and size / location of the lesion. Uterine artery embolization or surgical excision can be performed, as indicated 1. In general they are benign tumours with favourable prognosis.
Differential diagnosis
General imaging differential consderations include:
- benign cystic ovarian teratoma
- malignant degeneration of cystic teratoma
- non-teratomatous lipomatous ovarian tumour
- pelvic lipoma
- pelvic liposarcoma
- very rare lipomatous tumours of the uterus: angiomyolipoma, fibromyolipoma, myelolipoma
-<p>A <strong>uterine lipoleiomyoma</strong> results from the degeneration of smooth muscle cells of an ordinary <a href="/articles/uterine-leiomyoma">leiomyoma</a> and represent a rare benign tumour of the uterus<sup>1</sup>.</p><h4>Epidemiology</h4><p>Lipoleiomyomas have a reported incidence of 0.03-0.2% and are typically found in post-menopausal patients with typical uterine leiomyomas <sup>2</sup>.</p><h4>Clinical presentation</h4><p>Although most patients are asymptomatic, they can present with symptoms similar to leiomyomas of the same size and location. Symptoms include but are not limited to abdominal / pelvic pain, palpable mass and menstrual abnormalities.</p><h4>Pathology</h4><p>Many considered a uterine lipoleiomyoma as a distinct variety of leiomyoma. Histologically, it is composed of variable amounts of adipocytes and smooth muscle cells separated by thin fibrous tissue. The exact aetiology is not well known ; but is mostly thought tp represent fatty metamorphosis of the smooth muscle cells of a leiomyoma. Lesions can vary in size from a few mm to a few cm's.</p><h4>Radiographic features</h4><p>Advanced imaging of these lesions allow for differentiation from cystic ovarian neoplasms, which may require surgical therapy <sup>3</sup>.</p><h5>Pelvic ultrasound</h5><p>Lesions are typically hyper-echoic with a partially hypoechoic rim. This rim likely represents the layer of myometrium surrounding the fatty central component <sup>3</sup>. There is often poor vascularity seen on colour doppler examination</p><h5>CT</h5><p>Often seen as a predominantly fat containing well demarcated mass with areas of soft tissue density arising from uterus <sup>3</sup>.</p><h5>Pelvic MRI</h5><p>Secondary to the predominant fatty component in the lesion, hyperintensity is seen on T1 weighted sequences and chemical shift artifacts are noted. Additionally, fat suppression techniques can be useful in verifying the diagnosis - most of the lesion shows fat suppression <sup>3</sup>. Signal characteristics are therefore</p><ul>- +<p><strong>Uterine lipoleiomyomas</strong> result from degeneration of smooth muscle cells in an ordinary <a href="/articles/uterine-leiomyoma">leiomyoma</a> and represent a rare benign tumour of the uterus <sup>1</sup>.</p><h4>Epidemiology</h4><p>Lipoleiomyomas have a reported incidence of 0.03-0.2% and are typically found in post-menopausal patients with typical uterine leiomyomas <sup>2</sup>.</p><h4>Clinical presentation</h4><p>Although most patients are asymptomatic, they can present with symptoms similar to leiomyomas of the same size and location. Symptoms include but are not limited to abdominal / pelvic pain, palpable mass and menstrual abnormalities.</p><h4>Pathology</h4><p>Many considered a uterine lipoleiomyoma as a distinct variety of leiomyoma. Histologically, it is composed of variable amounts of adipocytes and smooth muscle cells separated by thin fibrous tissue. The exact aetiology is not well known ; but is mostly thought tp represent fatty metamorphosis of the smooth muscle cells of a leiomyoma. Lesions can vary in size from a few mm to a few cm's.</p><h4>Radiographic features</h4><p>Advanced imaging of these lesions allow for differentiation from cystic ovarian neoplasms, which may require surgical therapy <sup>3</sup>.</p><h5>Pelvic ultrasound</h5><p>Lesions are typically hyper-echoic with a partially hypoechoic rim. This rim likely represents the layer of myometrium surrounding the fatty central component <sup>3</sup>. There is often poor vascularity seen on colour doppler examination</p><h5>CT</h5><p>Often seen as a predominantly fat containing well demarcated mass with areas of soft tissue density arising from uterus <sup>3</sup>.</p><h5>Pelvic MRI</h5><p>Secondary to the predominant fatty component in the lesion, hyperintensity is seen on T1 weighted sequences and chemical shift artifacts are noted. Additionally, fat suppression techniques can be useful in verifying the diagnosis - most of the lesion shows fat suppression <sup>3</sup>. Signal characteristics are therefore</p><ul>
-<strong>T1 </strong>- high signal</li>- +<strong>T1:</strong> high signal</li>
-<strong>T1 FS</strong> - low signal</li>- +<strong>T1 FS:</strong> low signal</li>
-<strong>T2 -</strong> high signal</li>- +<strong>T2:</strong> high signal</li>
-<strong>T2 FS/STIR</strong> - low signal</li>-</ul><h4>Treatment and prognosis</h4><p>Treatment is similar to leiomyomas and is dependent on the clinical symptoms and size / location of the lesion. Uterine artery embolization or surgical excision can be performed, as indicated <sup>1</sup>. In general they are benign tumours with favourable prognosis.</p><h4>Differential diagnosis</h4><p>General imaging differential consderations include</p><ul>- +<strong>T2 FS/STIR</strong>: low signal</li>
- +</ul><h4>Treatment and prognosis</h4><p>Treatment is similar to leiomyomas and is dependent on the clinical symptoms and size / location of the lesion. Uterine artery embolization or surgical excision can be performed, as indicated <sup>1</sup>. In general they are benign tumours with favourable prognosis.</p><h4>Differential diagnosis</h4><p>General imaging differential consderations include:</p><ul>
-<li>very rare lipomatous tumours of the uterus : angiomyolipoma, fibromyolipoma, myelolipoma</li>- +<li>very rare lipomatous tumours of the uterus: angiomyolipoma, fibromyolipoma, myelolipoma</li>
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