|Year : 2017 | Volume
| Issue : 3 | Page : 163-164
Subserosal lipoleiomyoma of the cervix in a postmenopausal woman: A rare case report
Hema Basappa Bannur, Vijayalaxmi Veerbasappa Suranagi, Reshma Davanageri
Department of Pathology, KLEU's J.N. Medical College, Belgaum, Karnataka, India
|Date of Web Publication||14-Feb-2018|
Hema Basappa Bannur
Department of Pathology, KLEU's J.N. Medical College, Nehru Nagar, Belgaum - 590 010, Karnataka
Source of Support: None, Conflict of Interest: None
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
| Introduction|| |
Lipoleiomyomas are rare benign tumors, accounting for 0.03%–2.9% of all leiomyomas., 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|| |
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 2: Microphotograph showing smooth muscle cells interspersed with adipocytes (H and E, ×20)|
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| Discussion|| |
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. 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. Immunohistochemistry has revealed adipocytes to be reactive for vimentin, proposing the transformation of smooth muscle cells into adipocytes. Lopstein, in 1916, described histopathology of lipoleiomyoma for the first time. However, the term “lipoleiomyoma” was much later used by Willen et al. and Pounder., Majority of the myomas that appear on the cervix actually arise from the isthmus of the uterus., 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. 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.
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Conflicts of interest
There are no conflicts of interest.
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[Figure 1], [Figure 2]