Uterine lipoleiomyoma misdiagnosed as uterine fibroid in a pregnant woman: a case report and literature review

Uterine lipoleiomyoma is a rare variant of leiomyomas, especially in pregnant women. Currently, there is only one case reported in literature, suggesting that without proper knowledge about this disease, there is a high risk that uterine lipoleiomyoma could be misdiagnosed as other gynecological diseases, particularly during pregnancy. Here, we report the case of a 38-year-old female admitted to our department due to intermittent lower abdominal pain and a small amount of vaginal bleeding after menopause. Based on her clinical manifestations, laboratory tests and imaging examinations, she was preoperatively diagnosed as pregnant with uterine fibroid fatty degeneration. Following an induced abortion, she underwent a laparoscopic myomectomy and was diagnosed with uterine lipoleiomyoma on postoperative immunohistochemistry. During a 6-month follow-up, no abnormalities were detected. The obstetric outcomes, diagnosis and treatments of pregnancy with uterine lipoleiomyoma may resemble those of pregnancy with uterine fibroid. Although comprehensive imaging examinations are helpful for preoperative diagnosis, the final diagnosis still relies on postoperative pathological examination.

Misdiagnosis; Pregnancy; Uterine fibroid; Uterine lipoleiomyoma

[1] Ghosh B, McKeown B, Gumma A. Lipoleiomyoma. BMJ Case Reports 2011; 2011: bcr0820114577.

[2] Wilke S, Benson J, Roller L. Uterine lipoleiomyoma: case report and review of the literature. Radiology Case Reports. 2022; 17: 954–958.

[3] Nazir HM, Mehta S, Seena CR, Kulasekaran N. Uterine lipoleiomyoma: a report of two cases. Journal of Clinical Imaging Science 2017; 7: 26.

[4] Manila K, Laxmi M, Ranjana P. Cervical myolipoma with pregnancy: report of a case and brief review of literature. Nepal Journal of Obstetrics and Gynaecology. 2009; 4: 54–55.

[5] Yuan Y, Chen L, Zhao T, Yu M. Pathogenesis, diagnosis and treatment of uterine lipoleiomyoma: a review. Biomedicine & Pharmacotherapy. 2021; 142: 112013.

[6] Mulita F, Liolis E, Kehagias D. An enormous pelvic tumor in a 46-year-old woman with an elevated serum CA 125 level, what lies beneath it?Investigation of uterine tumors in postmenopausal women. Menopause Review. 2021; 20: 154–157.

[7] Tyagi N, Tyagi R, Griffin Y. Uterine lipoleiomyoma. BMJ Case Reports. 2014; 2014: bcr2014207763.

[8] Johari B, Koshy M, Sidek S, Hanafiah M. Lipoleiomyoma: a rare benign tumour of the uterus. BMJ Case Reports. 2014; 2014: bcr2014205814.

[9] Chu CY, Tang YK, Chan TS, Wan YH, Fung KH. Diagnostic challenge of lipomatous uterine tumors in three patients. World Journal of Radiology. 2012; 4: 58–62.

[10] Akbulut M, Gündoğan M, Yörükoğlu A. Clinical and pathological features of lipoleiomyoma of the uterine corpus: a review of 76 cases. Balkan Medical Journal. 2014; 31: 224–229.

[11] Mulita F, Iliopoulos F, Plachouri K, Kehagias I. Uterine leiomyoblastoma. BMJ Case Reports. 2021; 14: e241533.

Saleh HS, Mowafy HE, Hameid AAAE, Sherif HE, Mahfouz EM. Does uterine fibroid adversely affect obstetric outcome of pregnancy? BioMed Research International. 2018; 2018: 1–5.

Valenti G, Milone P, D’Amico S, Caldaci LMG, Vitagliano A, Sapia F, et al. Use of pre-operative imaging for symptomatic uterine myomas during pregnancy: a case report and a systematic literature review. Archives of Gynecology and Obstetrics. 2019; 299: 13–33.

[14] Zaima A, Ash A. Fibroid in pregnancy: characteristics, complications, and management. Postgraduate Medical Journal. 2011; 87: 819–828.