A case report of pelviscopic resection of lipoleiomyoma originating from the uterine cervix in a postmenopausal woman

Abstract

Rationale: Lipoleiomyoma is a rare neoplasm of the uterus. It is considered a variant of uterine myomas. Its reported incidence varies from 0.03% to 0.2%. Lipoleiomyoma consists of variable proportions of mature lipocytes and smooth muscle cells. These tumors generally occur in asymptomatic obese perimenopausal or postmenopausal women. About 90.7% of lipoleiomyomas arise from the uterine corpus, with only 6.5% arising from the cervix. When it occurs in the cervix, it is difficult to diagnose and treat it. We report an uncommon case of pelviscopic resection of uterine cervical lipoleiomyoma showing continuous growth after menopause. Patient concerns: A 55-year-old postmenopausal woman was diagnosed with 40 mm-sized uterine myoma 4 years ago. The size of the mass increased to 58mm in the last year. Diagnoses: An ultrasound scan revealed a 58×34-mm-sized round hyperechogenic and barely vascularity mass that appeared to have originated on the left side of the uterine cervix. Final pathologic findings showed lipoleiomyoma. Interventions: After admission to the hospital, we performed pelviscopic removal of uterine lipoleiomyoma and both tubes. Microscopic examination revealed a significant amount of fat cells between muscle cells. Outcomes: Surgeries were successful. The patient had been followed up regularly for three years after surgery. She did not experience any complications. She remained disease-free. Lessons: Although lipoleiomyomas mainly occur in postmenopausal women, they can also occur in the uterine cervix. They can increase in size after menopause. They can be removed laparoscopically. If a hyperechoic mass occurred in the uterus after menopause that keeps growing without symptoms, a differential diagnosis of lipoleiomyomas must be performed.