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CASE REPORT
Year : 2017  |  Volume : 44  |  Issue : 3  |  Page : 163-164

Subserosal lipoleiomyoma of the cervix in a postmenopausal woman: A rare case report


Department of Pathology, KLEU's J.N. Medical College, Belgaum, Karnataka, India

Date of Web Publication14-Feb-2018

Correspondence Address:
Hema Basappa Bannur
Department of Pathology, KLEU's J.N. Medical College, Nehru Nagar, Belgaum - 590 010, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jss.JSS_33_17

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  Abstract 

Uterine lipoleiomyomas are rare benign tumors in which there is admixture of smooth muscle cells and mature adipocytes. Cervical lipoleiomyomas are still rarer, occurring in obese perimenopausal and postmenopausal women. These tumors are usually asymptomatic and can be accidental finding in hysterectomy specimen. We present a case of subserosal cervical lipoleiomyoma in a postmenopausal woman who presented with III uterovaginal prolapse. Literature search reveals few cases reported so far.

Keywords: Cervix, lipoleiomyoma, prolapse, uterus


How to cite this article:
Bannur HB, Suranagi VV, Davanageri R. Subserosal lipoleiomyoma of the cervix in a postmenopausal woman: A rare case report. J Sci Soc 2017;44:163-4

How to cite this URL:
Bannur HB, Suranagi VV, Davanageri R. Subserosal lipoleiomyoma of the cervix in a postmenopausal woman: A rare case report. J Sci Soc [serial online] 2017 [cited 2018 May 23];44:163-4. Available from: http://www.jscisociety.com/text.asp?2017/44/3/163/225505


  Introduction Top


Lipoleiomyomas are rare benign tumors, accounting for 0.03%–2.9% of all leiomyomas.[1],[2] They not only occur mainly in the uterus, but can also occur rarely in the cervix, ovary, broad ligament, and retroperitoneum. Its overall incidence is 0.03%–2%. Histopathological examination is diagnostic.


  Case Report Top


A 58-year-old postmenopausal woman presented with mass per vagina of 6 month duration, with urinary disturbances for 2 weeks. Per speculum examination revealed a mass on the posterior lip of the cervix. Her routine hematological and serological investigations were within normal limits. She underwent vaginal hysterectomy with pelvic floor repair.

Received the specimen of uterus with cervix measuring 6 cm × 2.5 cm × 3 cm. A well-circumscribed mass was seen on the posterior lip of the cervix subserosally, measuring 4 cm × 3.5 cm × 3 cm. Cut section showed patent endometrial cavity with an intramural leiomyoma measuring 0.5 cm in diameter. The cervical growth was grayish-white with yellow areas [Figure 1]. Histopathological examination showed atrophic endometrium and myometrium with intramural leiomyoma. Sections from the cervical mass showed spindle-shaped, smooth muscle cells arranged in whorled pattern, admixed with mature adipocytes [Figure 2]. Nuclear pleomorphism, necrosis, or mitotic figures were not evident. Hence, a diagnosis of cervical lipoleiomyoma was given.
Figure 1: Gross specimen of the uterus with cervical lipoleiomyoma

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Figure 2: Microphotograph showing smooth muscle cells interspersed with adipocytes (H and E, ×20)

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  Discussion Top


Lipoleiomyomas are considered to be variant of leiomyomas. Cervical leiomyomas account for 1%–2% of all fibroids. They are of 3 types – supravaginal, interstitial, and polypoidal. They can be intramural or subserosal.[3] Histologically, lipoleiomyomas show smooth muscle cells and mature adipocytes. Many theories have been put forth to explain the presence of fat cells within the leiomyomas-fatty metamorphosis, metaplasia, or degeneration.[4] Immunohistochemistry has revealed adipocytes to be reactive for vimentin, proposing the transformation of smooth muscle cells into adipocytes.[3] Lopstein, in 1916, described histopathology of lipoleiomyoma for the first time.[5] However, the term “lipoleiomyoma” was much later used by Willen et al. and Pounder.[5],[6] Majority of the myomas that appear on the cervix actually arise from the isthmus of the uterus.[7],[8] Cervical lipoleiomyomas are usually small and asymptomatic and are incidental findings, or patients may present with vague lower abdominal pain. Ultrasound examination computed tomography or magnetic resonance imaging help in diagnosis. Histologically, differentials include benign cystic teratoma, spindle cell lipoma, atypical lipoma, angiolipoma, fibrolipoma, myelolipoma, and well-differentiated liposarcoma.[4] Lipoleiomyomas are treated in the same manner as leiomyomas. Asymptomatic lipoleiomyomas require no treatment. Otherwise uterine artery embolization, myomectomy, or hysterectomy are done.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Mondal R, Mondal K, Pramanik P. Gigantic lipoleiomyoma of cervix with extensive hyaline degeneration. Ann Pathol Lab Med 2015;2:183-5.  Back to cited text no. 1
    
2.
Prieto A, Crespo C, Pardo A, Docal I, Calzada J, Alonso P. Uterine lipoleiomyomas: US & CT findings. Abdom Imaging 2000;25:655-7.  Back to cited text no. 2
    
3.
Sharma S, Ahluwalia C, Mandal AK. A rare incidental case of lipoleiomyoma cervix. Asian Pac J Health Sci 2015;2:186-90.  Back to cited text no. 3
    
4.
Bolar F, Kayaseluch F, Canpolar J, Erkanli S, Tuncer I. Histogenesis of lipomatous component in uterine lipoleiomyomas. Turk J Pathol 2007;23:82-6.  Back to cited text no. 4
    
5.
Willen R, Gad A, Willen H. Lipomatous lesions of the uterus. Virchows Arch A Pathol Anat Histopathol 1978;377:351-61.  Back to cited text no. 5
    
6.
Pounder DJ. Fatty tumors of the uterus. J Clin Pathol 1982;35:1380-3.  Back to cited text no. 6
    
7.
Fagouri H, Hafidi MR, Guelzim K, Hakini I, Kouach J, Moussoui DR, et al. Lipoleiomyoma of the uterine cervix. Int J Sci Technol Res 2014;3:449-50.  Back to cited text no. 7
    
8.
Thomason P. Leiomyoma Uterus (fibroid). Omaha: Emedicine Inc.; 2008. Available from: http://www.eMedicine.com. [Last accessed on 2008 May 06].  Back to cited text no. 8
    


    Figures

  [Figure 1], [Figure 2]



 

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