Uterine Lipoma: An Incidental finding


This article presents a rare case of uterine lipoma diagnosed incidentally in a 70-year-old woman. The lady came to the outpatient department with a complaint of recurrent urinary tract infections. Upon examination, she had a large painless abdominal swelling. Her systemic history was non-significant. Moreover, the patient was hypertensive and hypercholesterolemic. She previously had two spontaneous vaginal deliveries. Furthermore, her vaginal exam showed vaginal prolapse.

The doctors investigated the case with a CT scan and pelvic ultrasound. CT scan showed a fatty mass and led to the differential diagnosis of uterine lipoleiomyoma while the pelvic ultrasound led to the differential diagnosis of dermoid. Both the imaging findings were conflicting, therefore the patient underwent an elective hysterectomy as well as a bilateral salpingo-oophorectomy.

Histopathological Examination of uterine lipoma

The specimen was sent for the histopathological exam for a definitive diagnosis. The uterus was 1666g in weight. The cut surface had a round yellow mass in the posterior wall with no haemorrhage or necrosis. Moreover, the fallopian tubes and ovaries were unremarkable. Microscopically, the mass was composed of benign mature adipocytes. There were septa with blood vessels and smooth muscles. There was no evidence of malignancy in adipocytes. Consequently, the definitive diagnosis was benign intramural uterine lipoma with focal smooth muscles around vessels.

The patient recovered after the surgery and three years into follow up, the patient developed no complications or recurrence.

Uterine Lipomas

Lipoma of the uterus is a rare benign tumour. It usually develops in a postmenopausal woman. Pure lipoma of the uterus is extremely rare. Most cases are asymptomatic and postoperative incidental findings while some may present with vaginal bleeding or pelvic discomfort. They are usually single but can also be multiple. The majority are intramural. They can be submucosal or subserosal. Malignant transformation is uncommon. Hence follow up is usually not required.


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