Uterine Lipoleiomyoma: A five year clinicopathological study.
Keywords:
Lipoleiomyoma, Histogenesis, Uterus
Abstract
Background: Uterine fatty tumors are rare benign neoplasms. Amongst them, uterine lipoleiomyoma is considered as a rare variant of uterine leiomyoma, constituting less than 0.2% of benign uterine tumors. Our study was aimed to investigate the spectrum of clinical and pathological features of uterine lipoleiomyoma with emphasis on its presumptive histogenesis and the possible origin of this tumor.Methods: This study was carried out in the Department of Pathology and Department of Obstretrics & Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India for a period of 5 years (January 2011 - December 2015). We retrospectively analyzed 589 women, who had undergone surgery for uterine leiomyomas or any gynaecological malignancies. The data obtained consisted of patient’s age, clinical presentation, radiological features, histopathology and immunohistochemistry (IHC) findings. The data collected was analyzed by descriptive statistics.Results: A total of 728 uterine leiomyoma and 10 lipoleiomyoma cases were seen. The patients age for lipoleiomyoma ranged from 30 to 75 years. Six cases were postmenopausal, three premenopausal and one reproductive age group woman. Two patients were diabetic, two had hypothyroidism while one had high triglyceride levels. On radiology, three cases were detected as uterine leiomyomas and in two cases a definite diagnosis of lipoleiomyoma could be established. Five patients had been operated for symptomatic leiomyomas (pelvic pain, menstrual disturbances) and rest five patients for gynaecological malignancies (cervical malignancy, endometrial carcinoma (2), ovarian teratoma, ovarian serous carcinoma). Its size ranged from 1 to 15 cm in diameter. Nine tumors were in the uterine corpus and one was in the cervix. No tumor displayed atypia, mitosis, necrosis, calcification, degenerative changes or prominent blood vessels. On IHC, the smooth muscle cells, pericytes, endothelial cells were positive for smooth muscle actin (SMA), desmin, vimentin while the adipocytes were positive for vimentin and were negative for estrogen receptor (ER), progesterone receptor (PR), Ki-67. There were no recurrences or tumor-related fatalities in follow up period of 6 months to 4 years.Conclusion: Uterine lipoleiomyoma is a benign fatty tumor with favourable outcome and complex histogenesis.References
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2. Sharma S, Ahluwalia C, Mandal AK. A Rare Incidental Case of Lipoleiomyoma Cervix. Asian Pac J Health Sci 2015; 2(1): 186-190.
3. Wang X, Kumar D, Seidman DJ. Uterine Lipoleiomyomas: A Clinicopathologic Study of 50 Cases. Int J Gynecol Pathol 2006;25:239-42.
4. Sudhamani S, Agrawal D, Pandit A, Kiri V M. Lipoleiomyoma of uterus: A case report with review of literature. Indian J Pathol Microbiol 2010;53:840-1.
5. Willen R, Gad A, Willen H. Lipomatous lesions of the uterus. Virchows Arch A Pathol Anat Histopathol 1978;377:351-61.
6. Pounder DJ. Fatty tumours of the uterus. J Clin Pathol 1982;35:1380-3.
7. Aung T, Goto M, Nomoto M, Kitajima S, Douchi T, Yoshinaga M, et al. Uterine lipoleiomyoma: A histopathological review of 17 cases. Pathol Int 2004;54:751-8.
8. Terada T. Huge lipoleiomyoma of the uterine cervix. Arch Gynecol Obstet 2011; 283(5):1169-71.
9. Terada T. Giant Subserosal Lipoleiomyomas of the Uterine Cervix and Corpus: A Report of 2
Cases. Appl Immunohistochem Mol Morphol 2012 Jan 26.[Epub ahead of print].
10. Schindl M, Birner P, Losch A, Breitenecker G, Joura EA. Preperitoneal lipoleiomyoma of the abdominal wall in a postmenopausal woman. Maturitas 2000;37:33-6.
11. Resta L, Maiorano E, Piscitelli D, Botticella MA. Lipomatous tumors of the uterus. Clinico-pathological features of 10 cases with immunocytochemical study of histogenesis. Pathol Res Pract 1994;190:378-83.
12. Bolat F, Kayaselçuk F, Canpolat T, Erkanli S, Tuncer I. Histogenesis Of Lipomatous Component In Uterine Lipoleiomyomas. Turkish Journal of Pathology 2007;23(2):82-6.
13. Sieinski W. Lipomatous neometaplasia of the uterus. Report of 11 cases with discussion of histogenesis and pathogenesis. Int J Gynecol Pathol 1989;8:357-63.
14. Havel G, Wedell B, Dahlenfor R, Mark J. Cytogenetic relationship between uterine lipoleiomyomas and typical leiomyomas. Virchows Archiv B Cell Pathol 1989;57:77-9.
15. Haust MD, Las Heras J, Harding PG. Fat-containing uterine smooth muscle cells in “toxemia”: possible relevance to atherosclerosis? Science 1977;195:1353-4.
16. Walid MS, Heaten RL. Case report of a cervical lipoleiomyoma with an incidentally discovered
ovarian granulosa cell tumor – imaging and minimal – invasive surgical procedure. German
Medical Science 2010; 8.
17. Tsushima Y, Kita T, Yamamoto K. Uterine lipoleiomyoma: MRI, CT and ultrasonographic findings. Br J Radiol 1997;70:1068-70.
18. Prieto A, Crespo C, Pardo A, Docal I, Calzada J, Alonso P. Uterine lipoleiomyomas: US and CT findings. Abdom Imaging 2000;25:655-7.
19. Su WH, Wang PH, Chang SP, Su MC. Preoperational diagnosis of a uterine lipoleiomyoma using ultrasound and computed tomography images: A case report. Eur J Gynaecol Oncol 2001;22:439-40.
20. Jouini S, Tawfik A, Alewa A, Wachuku E, Ayadi K. What’s your diagnosis? Subserosal uterine lipoleiomyoma fortuitously associated with endometrial carcinoma. Ann Saudi Med 2001;21:251-4.
21. McDonald AG, Dal Cin P, Ganguly A, Campbell S, Imai Y, Rosenberg AE, et al. Liposarcoma arising in uterine lipoleiomyoma: a report of 3 cases and review of the literature. Am J Surg Pathol 2011;35:221-7.
22. Vural C, Özen Ö, Demirhan B. Intravenous lipoleiomyomatosis of uterus with cardiac extension: A case report. Pathol Res Pract 2011;207:131-4.
2. Sharma S, Ahluwalia C, Mandal AK. A Rare Incidental Case of Lipoleiomyoma Cervix. Asian Pac J Health Sci 2015; 2(1): 186-190.
3. Wang X, Kumar D, Seidman DJ. Uterine Lipoleiomyomas: A Clinicopathologic Study of 50 Cases. Int J Gynecol Pathol 2006;25:239-42.
4. Sudhamani S, Agrawal D, Pandit A, Kiri V M. Lipoleiomyoma of uterus: A case report with review of literature. Indian J Pathol Microbiol 2010;53:840-1.
5. Willen R, Gad A, Willen H. Lipomatous lesions of the uterus. Virchows Arch A Pathol Anat Histopathol 1978;377:351-61.
6. Pounder DJ. Fatty tumours of the uterus. J Clin Pathol 1982;35:1380-3.
7. Aung T, Goto M, Nomoto M, Kitajima S, Douchi T, Yoshinaga M, et al. Uterine lipoleiomyoma: A histopathological review of 17 cases. Pathol Int 2004;54:751-8.
8. Terada T. Huge lipoleiomyoma of the uterine cervix. Arch Gynecol Obstet 2011; 283(5):1169-71.
9. Terada T. Giant Subserosal Lipoleiomyomas of the Uterine Cervix and Corpus: A Report of 2
Cases. Appl Immunohistochem Mol Morphol 2012 Jan 26.[Epub ahead of print].
10. Schindl M, Birner P, Losch A, Breitenecker G, Joura EA. Preperitoneal lipoleiomyoma of the abdominal wall in a postmenopausal woman. Maturitas 2000;37:33-6.
11. Resta L, Maiorano E, Piscitelli D, Botticella MA. Lipomatous tumors of the uterus. Clinico-pathological features of 10 cases with immunocytochemical study of histogenesis. Pathol Res Pract 1994;190:378-83.
12. Bolat F, Kayaselçuk F, Canpolat T, Erkanli S, Tuncer I. Histogenesis Of Lipomatous Component In Uterine Lipoleiomyomas. Turkish Journal of Pathology 2007;23(2):82-6.
13. Sieinski W. Lipomatous neometaplasia of the uterus. Report of 11 cases with discussion of histogenesis and pathogenesis. Int J Gynecol Pathol 1989;8:357-63.
14. Havel G, Wedell B, Dahlenfor R, Mark J. Cytogenetic relationship between uterine lipoleiomyomas and typical leiomyomas. Virchows Archiv B Cell Pathol 1989;57:77-9.
15. Haust MD, Las Heras J, Harding PG. Fat-containing uterine smooth muscle cells in “toxemia”: possible relevance to atherosclerosis? Science 1977;195:1353-4.
16. Walid MS, Heaten RL. Case report of a cervical lipoleiomyoma with an incidentally discovered
ovarian granulosa cell tumor – imaging and minimal – invasive surgical procedure. German
Medical Science 2010; 8.
17. Tsushima Y, Kita T, Yamamoto K. Uterine lipoleiomyoma: MRI, CT and ultrasonographic findings. Br J Radiol 1997;70:1068-70.
18. Prieto A, Crespo C, Pardo A, Docal I, Calzada J, Alonso P. Uterine lipoleiomyomas: US and CT findings. Abdom Imaging 2000;25:655-7.
19. Su WH, Wang PH, Chang SP, Su MC. Preoperational diagnosis of a uterine lipoleiomyoma using ultrasound and computed tomography images: A case report. Eur J Gynaecol Oncol 2001;22:439-40.
20. Jouini S, Tawfik A, Alewa A, Wachuku E, Ayadi K. What’s your diagnosis? Subserosal uterine lipoleiomyoma fortuitously associated with endometrial carcinoma. Ann Saudi Med 2001;21:251-4.
21. McDonald AG, Dal Cin P, Ganguly A, Campbell S, Imai Y, Rosenberg AE, et al. Liposarcoma arising in uterine lipoleiomyoma: a report of 3 cases and review of the literature. Am J Surg Pathol 2011;35:221-7.
22. Vural C, Özen Ö, Demirhan B. Intravenous lipoleiomyomatosis of uterus with cardiac extension: A case report. Pathol Res Pract 2011;207:131-4.
Published
2016-05-12
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