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Case of the Week 7 2019

*56-year-old female present with pelvic pain.

What is the most likely diagnosis?

Answer

Answer: Uterine lipoleiomyoma

Case Discussion:

MR images revealed the uterine lipoleiomyoma.

Uterine lipoleiomyomas result from degeneration of smooth muscle cells in an ordinary leiomyoma and represent a rare benign tumor of the uterus. They have a reported incidence of 0.03-0.20% and are typically found in postmenopausal patients with typical uterine leiomyomas.

MRI
T1: hyperintensity
T1 FS: hypointensity
T2: hyperintensity
T2 FS or STIR: hypointensity

Differential diagnosis:
benign cystic ovarian teratoma
malignant degeneration of cystic teratoma
non-teratomatous lipomatous ovarian tumor
pelvic lipoma
pelvic liposarcoma

References:
1. Prieto A, Crespo C, Pardo A et-al. Uterine lipoleiomyomas: US and CT findings. Abdom Imaging. 25 (6): 655-7.
2. Tsushima Y, Kita T, Yamamoto K. Uterine lipoleiomyoma: MRI, CT and ultrasonographic findings. Br J Radiol. 1997;70 (838): 1068-70.