Table of Contents  
Year : 2017  |  Volume : 10  |  Issue : 4  |  Page : 384-385  

Uterine intramural lipoma: A benign but rare entity

Department of Pathology, Government Medical College, Kota, Rajasthan, India

Date of Submission18-Sep-2016
Date of Acceptance09-Nov-2016
Date of Web Publication4-Sep-2017

Correspondence Address:
Deepti Sukheeja
C/O Mr. O. P. Sukheeja, 1, Vigyan Nagar Special, Near P and T Colony, Vigyan Nagar, Kota - 324 005, Rajasthan
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0975-2870.213931

Rights and Permissions

Lipoma of the uterus is a rare benign tumor, usually developing in postmenopausal woman. Clinical symptoms and physical signs are similar to those found in leiomyomas. Most are postoperative chance finding following hysterectomy for leiomyoma. A 50-year-old postmenopausal woman presented with vaginal prolapse. The hysterectomy specimen showed an intramural lipoma of the uterus. The diagnosis of pure lipoma of the uterus should be made when any smooth muscle if present is confined to the periphery of the tumor composing of mature adipocytes. Our case highlights the importance of this benign but rare entity.

Keywords: Pure lipoma, uterovaginal prolapse, uterus

How to cite this article:
Pathak V, Sukheeja D, Singh RK. Uterine intramural lipoma: A benign but rare entity. Med J DY Patil Univ 2017;10:384-5

How to cite this URL:
Pathak V, Sukheeja D, Singh RK. Uterine intramural lipoma: A benign but rare entity. Med J DY Patil Univ [serial online] 2017 [cited 2023 Apr 1];10:384-5. Available from:

  Introduction Top

Intramural lipoma of the uterus is extremely rare, and only a few cases have been reported so far.[1] Decades before it led to differential diagnostic problems, but with latest imaging techniques, it can be diagnosed preoperatively as well. We are reporting a case of intramural lipoma of the uterine corpus in a postmenopausal woman which was an incidental finding in a hysterectomy specimen.

  Case Report Top

A 50-year-old postmenopausal woman underwent vaginal hysterectomy for uterovaginal prolapse. Grossly, the uterus with cervix measured 9 cm × 5 cm × 4 cm with slight widening of the body of the uterus. Cut surface showed a well-circumscribed greasy, yellow intramural mass of 1.5 cm diameter with patent endometrial cavity. No concomitant fibroid or any other lesion seen [Figure 1]a. Microscopically, tumor was composed of mature adipose tissue with an occasional vessel. No smooth muscle cells or fibrous elements were seen within the tumor. The smooth muscle fibers were pushed to periphery forming a capsule along with fibrous tissue [Figure 1]b. There was no associated sarcomatous component. The diagnosis of pure intramural lipoma of the uterus was made.
Figure 1: (a) Gross photograph of the specimen of intrauterine lipoma. (b) Microphotograph showing adipose tissue surrounded by smooth muscle fibers at the periphery (H and E, ×100)

Click here to view

  Discussion Top

Pure lipoma of the uterus is extremely rare.[1] The reported incidence is approximately 0.03%–0.2%.[2] About 90% of these occur in postmenopausal women.[3] A majority of cases are asymptomatic and postoperative incidental finding while some may present with vaginal bleeding or pelvic discomfort, symptoms similar to leiomyoma of comparable size,[4] and some may coexist also. However, leiomyomas commonly present in younger, premenstrual women. They arise in the uterine corpus predominantly [1] are usually single but can be multiple. Majority are intramural. They can be submucosal or subserosal.[2] The size ranges from few millimeters to as large as 32 cm.[5] Largest series reported is of ten cases, of which one was pure lipoma and nine were lipoleiomyomas.[6] Uterine lipomas are at one pole of spectrum of uterine fatty tumors composed entirely of adipocytes [7] can be intermixed with various connective tissues or smooth muscle in varying proportions hence labeled as pure lipoma, lipoleiomyomas, and lipofibroma. The largest series of pure lipoma is reported by Lau and Thoeni of three cases.[8] These tumors are of unknown histogenesis and nomenclature. Histogenesis is controversial, from pluripotent connective tissue cell.[9] Other theories proposed are emplaced embryonic fat cells, metaplasia of muscle or connective tissue into fat cells, proliferation of perivascular fat cells, fatty infiltration or degeneration of connective tissue,[1],[3] or inclusion during surgery. More common fatty tumors are lipoleiomyomas, angiolipomas, or benign mixed mesodermal tumors. Lipomas make a sporadic but unproven relationship with endometrial carcinoma.[6] In the preimaging era, they were mainly diagnosed on postoperative specimens or at autopsy. However, nowadays due to the advancement in radiological imaging techniques, they can be diagnosed preoperatively, obviating the need of an unnecessary operation, and panic because of its benign nature. Malignant transformation is extremely rare [7] and hence follow-up is not required usually.

On ultrasonography, they are well defined and hyperechoic lesions because of their fat content. Furthermore, they are avascular. The smooth muscle presents on the periphery of lipoma appear as hypoechoic rim. However, calcification in leiomyoma mimics it, so confirmation by magnetic resonance imaging (MRI) is required. A uterine lipoma would appear as high signal on T1 and T2 sequences and shows signal dropout on fat thus confirming the diagnosis. MRI also differentiates these from adnexal masses and highlights internal components. A pure lipoma should not have a soft-tissue component.[9] Thus, an accurate diagnosis in asymptomatic postmenopausal women where uterine lipoma is an incidental finding is of utmost importance.

  Conclusion Top

The importance of this lesion lies in the fact that they occur in postmenopausal women. They are either asymptomatic or can present with pain abdomen and rapidly increasing abdominal mass, and ultrasonography reveals a hyperechoic mass giving a wrong perception of sarcoma. However, with recent imaging modalities, they can be correctly diagnosed preoperatively as well, and unnecessary surgery and panic can be avoided in asymptomatic patients.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Fernandes H, Naik CN, Swethadri GK, Bangera I, Miranda D. Pure lipoma of the uterus: A rare case report. Indian J Pathol Microbiol 2007;50:800-1.  Back to cited text no. 1
Brandfass RT, Everts-Suarez EA. Lipomatous tumors of the uterus; a review of the world's literature with report of a case of true lipoma. Am J Obstet Gynecol 1955;70:359-67.  Back to cited text no. 2
Dharkar DD, Kraft JR, Gangadharam D. Uterine lipomas. Arch Pathol Lab Med 1981;105:43-5.  Back to cited text no. 3
Jacobs JE, Markowitz SK. CT diagnosis of uterine lipoma. AJR Am J Roentgenol 1988;150:1335-6.  Back to cited text no. 4
Deb S, Harith AK, Bhatnagar PK. Uterine lipoma – A rare entity. Med J Armed Forces India 2005;61:385-6.  Back to cited text no. 5
Pounder DJ. Fatty tumours of the uterus. J Clin Pathol 1982;35:1380-3.  Back to cited text no. 6
Kovács J, Póka R. Lipoma of the uterus. Pathol Oncol Res 1996;2:181-3.  Back to cited text no. 7
Lau LU, Thoeni RF. Case report. Uterine lipoma: Advantage of MRI over ultrasound. Br J Radiol 2005;78:72-4.  Back to cited text no. 8
Mignogna C, Di Spiezio Sardo A, Spinelli M, Sassone C, Cervasio M, Guida M, et al. A case of pure uterine lipoma: Immunohistochemical and ultrastructural focus. Arch Gynecol Obstet 2009;280:1071-4.  Back to cited text no. 9


  [Figure 1]

This article has been cited by
1 Pure Uterine Lipoma: A Report of a Rare Entity
Kayan S Alfarra, Ayesha A Aldhamer, Hiba S Aldubaib, Majd A Majoun, Aisha S Alrammah, Fedaa S Alshehri, Hanan M Mughallis, Awatif J Almalki, Ghadeer G Basakran, Areej M Alayed, Ghadah A Fallatah, Shahad F Alanazi, Amnah S Alamri, Omnia O Abuzahirah, Faisal Al-Hawaj
Cureus. 2021;
[Pubmed] | [DOI]
2 Pure Uterine Lipoma and Focal Nodular Hyperplasia of the Liver: Concurrence of a Rare Tumor and Another Incidental Finding
Mohammad Hossein Anbardar,Neda Soleimani,Seyed Ali Malek-Hosseini,Shirin Moradmand,Cheryl Ann Palmer
Case Reports in Pathology. 2020; 2020: 1
[Pubmed] | [DOI]


    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

  In this article
Case Report
Article Figures

 Article Access Statistics
    PDF Downloaded184    
    Comments [Add]    
    Cited by others 2    

Recommend this journal