IS Case 188: Uterine lipoleiomyoma

Samuel Madoff, MD

Imaging Sciences URMC 2008
Publication Date: 2009-05-22

History

A 50-year-old female presented with right lower quadrant pain.

Diagnosis

Uterine lipoleiomyoma

Discussion

A lipoleiomyoma is a benign uterine tumor containing primarily mature adipose tissue and secondarily smooth muscle and/or fibrous tissue. Lipomatous uterine tumor is a synonym.

Lipoleiomyomas are commonly asymptomatic. Symptoms, when present, are similar to any other uterine leiomyoma: uterine bleeding; pelvic discomfort, heaviness or pressure.

These may be diagnosed with ultrasound, computed tomography (CT) or magnetic resonance (MR) imaging. On ultrasound, the mass appears quite echogenic, a pathognomonic finding. There is accompanying posterior acoustic shadowing.

CT demonstrates lipoleiomyomas as low attenuation lesions (< 20 HU). MR reveals a lesion that follows subcutaneous fat signal on all sequences. It is important to differentiate a lipoleiomyoma from a cystic ovarian teratoma, as the latter necessitates excision.

References

  1. Tsushima Y, Kita T, Yamamoto K. Uterine lipoleiomyoma: MRI, CT and ultrasonographic findings. Br J Radiol. 1997 Oct;70(838):1068-70. [PMID: 9404215]
  2. Noel P, Reinhold C. Lipomatous uterine tumors. IN: Diagnostic Imaging: Gynecology. Lippincott Williams & Wilkins: 2007.

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