http://dx.doi.org/10.5455/2320-1770.ijrcog20150449 Volume 4 · Issue 2 Page 508 International Journal of Reproduction, Contraception, Obstetrics and Gynecology Samal S et al. Int J Reprod Contracept Obstet Gynecol. 2015 Apr;4(2):508-510 www.ijrcog.org pISSN 2320-1770 | eISSN 2320-1789 Case Report Lipoleiomyoma in a postmenopausal woman: an incidental finding Sunita Samal 1 *, Sunil Kumar Samal 1 , Jasmina Begum 1 , Anandraj Vaithy 2 INTRODUCTION Primary fatty tumours of the uterus are very uncommon and almost invariably benign. 1 These tumors most probably represent tumour metaplasia within a leiomyoma. There is no definite accepted nomenclature for such tumours and it is suggested that they be designated "uterine fatty tumours" and subdivided into “lipoma” and “mixed lipoma/leiomyoma” (synonym lipoleiomyoma). 2 Their reported incidence varies from 0.03 to 0.2%. 3 The usual site of occurrence is within the abdominal cavity and retroperitoneum, although it may also be found in the subcutis and muscular fascia. 4 Lipoleiomyoma is comprised of smooth muscle cells along with diffuse and scattered lobules of adipose tissue showing whorling at places. These tumours are seen in uterus as intramural growths but rarely may be seen arising in cervix and in broad ligament. 5 It generally occurs in asymptomatic obese perimenopausal or menopausal women. We report a case of uterine lipoleiomyoma because of its rarity. CASE REPORT A 61 year old, multiparous postmenopausal woman presented with intermittent lower abdominal pain of 10 days duration. She attained menopause at 50 years of age. She was a known case of hypertension, diabetes mellitus and hypothyroid on treatment for last 8 years. Pelvic examination showed 14 weeks size mass which was non tender, firm and mobile. Ultrasonography revealed a uterine mass close to fundus measuring 9×8×8 cm suggestive of fibroid but possibility of ovarian teratoma was not ruled out. Endometrial thickness was 7 mm and both the ovaries were sonologically normal. All the standard serological and hematological parameters were within normal range. As ovarian teratoma was one of the differential diagnosis, tumor markers were tested which were within the normal limit. After control of hypertension and diabetic status, she underwent total abdominal hysterectomy with bilateral salpingo- oophorectomy because of the large subserous fibroid. On gross examination uterine fundus showed a solid mass of 9×8cm which was yellow in colour on cut section (Figure 1 Department of Obstetrics & Gynaecology, MGMC & RI, Puducherry, India 2 Department of Pathology, MGMC & RI, Puducherry, India Received: 12 February 2015 Revised: 14 February 2015 Accepted: 01 March 2015 *Correspondence: Dr. Sunita Samal, E-mail: sunisamal@rediffmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Lipoleiomyomas are rare variants of uterine leiomyoma, in spite of relatively common occurrence of leiomyomas of uterus. Their reported incidence varies from 0.03 to 0.2%. These tumors generally occur in asymptomatic obese perimenopausal or menopausal women. The presence of fatty tissue in the myometrium is interpreted as lipomatous degeneration, smooth muscle metaplasia or as a benign tumour called as lipoleiomyoma. Imaging can play an important role in determining the intrauterine location and fatty nature of lipoleiomyomas but most of these are detected incidentally in histopathological findings postoperatively. We report a case of lipoleiomyoma in fundus of uterus in 61 years old postmenopausal female, who presented with on and off abdominal pain. Keywords: Lipoleiomyoma, Menopause, Smooth muscle, Uterus DOI: 10.5455/2320-1770.ijrcog20150449