Fact-sheet: Uterine lipoleiomyoma
Updated on 10/06/2017 at 4:32 PM
View all RADEOS cases associated with this fact-sheet
Definition
Benign tumor, rare form of uterine leiomyomas
-Frequency: 0.05 to 0.2%, association with uterine fibroids: 2.1%
-Obese patients, peri- or post-menopausal
Pathophysiological hypotheses:
->metaplasia of smooth muscle cells or connective tissue into adipocytes
->abnormal migration of embryonic fat cells
->inclusion of fat cells into uterine leiomyomas during surgical procedures
Clinical features
Most often asymptomatic or pelvic heaviness, menometrorrhagia
Ultrasound
Hyperechoic mass, hypoechoic halo (uterine parenchyma), non-specific
CT
-Heterogeneous mass containing negative-density fatty areas disseminated within the lesion
-Sometimes difficult to identify the uterine origin with certainty. The sometimes subserosal nature of this type of lesion may wrongly suggest an ovarian origin
MRI
Heterogeneous T2 signal
Areas of T1 hyperintensity, disappearing on FAT-SAT sequences
Management
Exceptional malignant degeneration, possible association with endometrial carcinoma
Treatment:
-Watchful waiting if asymptomatic
-Treatment similar to uterine fibroids if symptomatic
Classification
Uterine lesions with fatty component:
Uterine lipomatoses: 0.03 to 0.2%
3 groups:
-Pure lipomas (purely fatty and encapsulated) very rare
-Mixed lipomas (lipoleiomyomas the most frequent, angiomyolipomas, fibrolipomas..)
-Liposarcomas
Differential diagnosis
Differential diagnosis: mature juxta-uterine teratoma of ovary.
