A Subserosal Uterine Lipoleiomyoma Mimicking a Mature Ovarian Teratoma

A 47-year-old woman presented to the gynecology clinic for an assessment of a pelvic mass that had been accidentally discovered in a recent physical examination. She was asymptomatic at presentation and tumor markers were normal. A confirmatory ultrasonography revealed a lipid-containing mass, measuring 3.8 cm × 3.5 cm × 3.0 cm, on the surface of the left ovary (Fig. 1), a finding that was suggestive of a mature ovarian teratoma. However, exploratory laparoscopy revealed a uterine lesion bulging out of the serosa with a clear boundary and located immediately beside the left ovary (Fig. 2). Lesion resection was performed. Histopathological assessment revealed a large proportion of adipocytes interspersed in mature smooth muscle cells that were arranged in bundles and whirlpools (Fig. 3), thus confirming a final diagnosis of uterine lipoleiomyoma. The postoperative recovery was uneventful and the patient was discharged home on the second day after surgery. Lipoleiomyoma is a benign lesion that is not commonly involved in the uterus [ 1 Tyagi N Tyagi R Griffin Y Uterine lipoleiomyoma. BMJ Case Rep. 2014; 2014 (bcr2014207763) Crossref Scopus (8) Google Scholar , 2 Alsaif JM Alali ZS Elsharkawy T Ahmed A Uterine lipoleiomyoma: a case report and review of literature. Cureus. 2021; 13: e20297 Google Scholar ]. Subserosal uterine lipoleiomyoma is generally asymptomatic [ 3 Wilke S Benson J Roller L Uterine lipoleiomyoma: case report and review of the literature. Radiol Case Rep. 2022; 17: 954-958 Crossref Scopus (1) Google Scholar ]. The expansive growth mode of uterine lipoleiomyoma and its lipid-containing characteristics led to ultrasonic confusion with a mature ovarian teratoma. The diagnosis was corrected by direct vision with a laparoscope and histopathological analysis. Fig. 2Laparoscopic imaging. View Large Image Figure Viewer Download Hi-res image Fig. 3Histopathology (hematoxylin and eosin stain, × 200). View Large Image Figure Viewer Download Hi-res image