Pure Uterine Lipoma with a Combined Mucinous Cystic and Brenner Ovarian Tumor in a Postmenopausal Woman: A Case Report and Review of the Literature

Lipomatous tumors are rare among uterine mesenchymal tumors. Due to their rarity, information on the clinical development and histological origin are lacking. We report a pure uterine lipoma and present a review of the relevant literature. We encountered a 72-year-old postmenopausal woman who was referred to our hospital. Computed tomography (CT) and magnetic resonance imaging (MRI) examinations revealed degenerative uterine tumors and a left ovarian cystic tumor with a solid portion. Total hysterectomy and bilateral salpingo-oophorectomy were performed, and postoperative histological examination revealed a uterine lipoma and adenomyosis. The cystic portion was a mucinous cystadenoma, and the solid portion was classified as a Brenner tumor. The postoperative course was uneventful, and the patient was discharged and remained well until follow-up. Our observations suggest that imaging examinations are sufficient for the diagnosis of uterine lipomatous tumors. To the best of our knowledge, the coexistence of a pure uterine lipoma and a mucinous Brenner ovarian tumor has not been documented in the existing literature. The histogenesis of uterine lipomas remains unclear. However, our results, and those from the existing literature, indicate that the mesenchymal stem cells surrounding the perivascular tissue may be implicated, because lipomas of the skin are reported to originate from these cells.

Pure Uterine Lipoma and Focal Nodular Hyperplasia of the Liver: Concurrence of a Rare Tumor and Another Incidental Finding

Background. Fatty uterine tumors, especially pure uterine lipoma, are very rare, but clinically and radiologically, they can mimic other primary benign and malignant uterine neoplasms. Case Report. A multipara 61-year-old postmenopausal woman presented with abnormal vaginal bleeding for 3 months. Assessment by ultrasound and magnetic resonance imaging (MRI) revealed a hyperechoic mass in the uterine corpus. Furthermore, during radiologic investigation, there was an incidental isoechoic mass in the left lobe of the liver. Pure uterine lipoma and hepatic focal nodular hyperplasia were diagnosed. Conclusion. Pure lipoma of the uterus, even though rare, has to be kept in the differential diagnosis of uterine neoplasms, especially in postmenopausal women. Till now, just a few concurrent tumors have been reported with pure uterine lipoma, and among them, FNH is the first extragenital tumor.

A Large Pure Uterine Lipoma: Its Diagnosis by Pelvic MRI and Histopathology

The patient is a 74-year-old female previously diagnosed with an ovarian tumor at age 55. No changes were noted for one year; however, she was lost to follow-up. Eighteen years later, she presented to a local clinic complaining of diffuse abdominal and flank pain. Abdominal and pelvic ultrasound, CT, and gynecological examination showed a fatty pelvic tumor of approximately 12 cm in diameter. A left ovarian teratoma was suspected, and per the patient’s request, she was transferred to Kobe Adventist Hospital for further evaluation and treatment. Pelvic MRI revealed no ovarian enlargement; however, a mass in the uterine body was appreciated with a high signal on T1 and T2 images and signal dropout in the fat suppression images, a finding most consistent with a uterine lipoma. A total hysterectomy and bilateral salpingo-oophorectomy was performed, and histopathological examination confirmed the preliminary diagnosis. No complications were observed during the postoperative period. A pure uterine lipoma is an extremely rare tumor with only a few cases reported worldwide. It is a benign tumor; however, it can sometimes be misdiagnosed as a malignant neoplasm. Pelvic MRI appears to be a useful tool in order to make the correct diagnosis preoperatively.