A rare case of pure uterine giant lipoma

Abstract

We encountered a rare case of uterine pure giant lipoma. Pure lipoma of the uterus is a very rare entity with an estimated occurrence of 0.03e0.12% [1,2]. To date, the histogenesis of lipomatous tumors has not been determined. A 73-year-old woman complained a sensation of pelvic heaviness and severe urge incontinence. Ultrasound showed an enlarged uterus, 16 weeks' size, with a round hyperechogenic lesion of 15 cm 14 cm, compressing the bladder and a bladder compression. Endometrial thickness was dislocated by the voluminous lesion. Magnetic resonance imaging (Figure 1A) showed the presence of two lesions with low-intensity signals (4 cm 3.2 cm; 2 cm 2.8 cm) and another one with a high-intensity signal on T1-weighted images (15 cm 12 cm). A hysteroscopic specimen showed atrophic endometrium. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Hysterectomy revealed an enlarged uterus (19 cm 11 cm 13 cm) due to the presence of three globular masses, which appeared as well-circumscribed intramural tumors. The lipoma was the largest of these globular masses, soft in consistency and homogeneously yellow (Figure 1B). No smooth muscle cells or fibrous elements were present intratumorally (Figure 1C, D); therefore, it was diagnosed as a pure lipoma [1].