A rare case of uterine lipo-leiomyoma in a 63-year-old Nigerian woman; a case report

Abstract

Background: Lipo-leiomyoma accounts for about 0.03%-0.2% of uterine tumours. The aetiology of lipo-leiomyoma is unclear, with some suggesting fatty metamorphogenesis and others involving growth factors and oestrogens. Radiological evaluation and histology are necessary for definitive diagnosis. If asymptomatic, no treatment is needed, but surgical resection is performed in symptomatic patients.

Case Presentation: This was a case of a 63-year-old Nigerian woman who experienced pelvic pain and heaviness for a year, worsening pelvic pain and distension, and post-menopausal bleeding. Abdominal examinations revealed a pelvic mass, vaginal examination showed no vaginal and cervical lesions, while abdominopelvic ultrasonography (USS) unveiled a hyperechoic mass in the posterior uterus. She underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy. Histopathological assessment of the samples showed a confirmatory diagnosis of uterine lipo-leiomyoma.

Conclusion: Lipo-leiomyoma is a rare, distinct uterine pathology that should be considered a differential diagnosis in post-menopausal women with vaginal bleeding. Total abdominal hysterectomy and bilateral salpingo-oophorectomy are recommended for menopausal women with symptomatic disease to prevent recurrent anaemia and also remove possible sites of the tumour even as the patient is unlikely to conceive again. Histopathological evaluation is crucial for post-menopausal women with coexisting bleeding per vagina.