5. Multiple uterine lipomata: First case report

Abstract

Background: Although lipoma is the most common soft tissue tumour, pure uterine lipoma is exceptionally rare. There is only a handful of reports of this entity. Uterine lipoma often shows non-specific clinical and frequently worrisome radiological features. Aims: The aim of this report is to shed the light on a rare diagnostic entity with broad differential diagnosis, which can occasionally raise concern for malignancy radiologically. To date, no previous reports of multiple uterine lipomata are identified in the literature. Methods: We report a case of 59-year-old woman with features of fibroid uterus. Radiologically, multiple benign leiomyomata were suspected. A total laparoscopic hysterectomy was performed. Gross examination revealed three intramural fatty masses ranging in size between 2 and 8 cm. Microscopically the tumours were composed of mature adipocytes separated by thin fibrovascular septae. No leiomyomata were identified. There was no evidence of atypia or malignancy. Conclusions: This is the first report of multiple intramural benign lipomata in a uterus. Previous cases of a single uterine lipoma have been reported. A uterine lipoma can be mistaken for carcinomas, especially in older patients with rapid progression. Several theories have been proposed as an explanation, including fatty tissue metaplasia, misplaced embryonic adipocytes and proliferation of perivascular fat cells. The presence of multiple uterine lipomata in our case suggests a histogenic proclivity to form these lesions beyond a mere incidental lipomatous differentiation. Further studies may help better understanding of this peculiar condition.