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Introduction: Lipoleiomyomas are unusual benign neoplasms of soft tissue, considered a variant of leiomyoma. Reported incidence varies from 0.03 to 0.2%. The blood supply within these tumors is tenuous, and thus ischemia and necrosis develop frequently in myomas. Following necrosis, their smooth muscle in replaced with various degenerative substances. Forms include hyaline, calcific, cystic, mysoid, red. and farty, and these gross changes should be recognized as normal variants. Uterine leiomyomas are estrogen-and progesterone-sensitive tumors. These are rare in adolescence, but rates rise with age during the reproductive year. More common in African-American women compared with white, Asian, or Hispanic women (Marshall,1997). Thus, heredity and gene mutations play a seminal role in myoma development. This study presents a rare case of lipoleiomyoma of the uterus in a postmenopausal woman with metabolic syndrome.. Aims and Objectives: To highlight the clinical, pathological, and immunohistochemical features of uterine lipoleiomyoma and discuss diagnostic challenges. To emphasize the importance of thorough histopathological examination with immunohistochemistry for accurate diagnosis and ruling out malignancy. Material and Methods: A 60-year-old postmenopausal female with obesity, type II diabetes, and hypertension presented with bleeding and pelvic mass. Total abdominal hysterectomy was performed, and the specimen was sent for histopathological examination. Hematoxylin and eosin-stained sections were analyzed, and immunohistochemistry (IHC) with desmin, smooth muscle actin (SMA), HMB-45, and Ki-67 was performed. Results: Grossly, the bulky uterus showed a well-circumscribed solid mass with a fibrolipomatous appearance. Microscopic examination revealed mature adipocytic lobules along with interlacing bundles of smooth muscle fibers (IHC: desmin positive, SMA negative, confirming smooth muscle differentiation). Separately, sent soft tissue mass showed a well-encapsulated benign neoplasm composed of mature adipocytes separated by fibrous septa along with interlacing bundles of smooth muscle cells. No necrosis, hemorrhage or lipoblasts were noted. IHC was HMB-45 negative, ruling out benign metastasizing leiomyoma. Ki-67 proliferative index was low (<2%), suggesting a benign nature. Conclusions: Uterine lipoleiomyoma is a very rare benign variant, posing diagnostic challenges clinically and on imaging. The tumor consists of long intersecting bundles of bland, smooth muscle cells admixed with nests of mature fat cells and fibrous tissue. These occur in different locations including cervix and ovaries resulting from fatty metamorphosis of uterine smooth muscle cells which can proceed to form localized or diffuse mature adipocyte tissue in leiomyoma or in the myometrium rather than fatty degeneration. Histopathological examination with a comprehensive IHC panel is crucial to confirm the final diagnosis, exclude malignancy like lipoleiomyosarcoma, and determine appropriate management in peri/postmenopausal obese females with metabolic syndrome.