Fujiwaki Ritsuto, Ohnuma Hideyuki, Miura Hiroshi, Sawada Kohji
Department of Obstetrics and Gynecology, Matsue Red Cross Hospital, Matsue, Japan.
Arch Gynecol Obstet. 2008 May;277(5):471-4. doi: 10.1007/s00404-007-0502-6. Epub 2007 Nov 7.
Uterine lipoleiomyoma is a rare, fat-containing, benign tumor. The clinical features and optimal treatment of this tumor remain unclear.
An 80-year-old woman with an extensive cardiac history was referred for assessment of a huge pelvic mass. Magnetic resonance imaging demonstrated a uterine tumor with inhomogeneously high signal intensity. A fat suppression technique showed heterogeneous suppression of the signal intensity, with areas of increased enhancement after Gd-DTPA administration. Hysteroscopy revealed no abnormal findings in the endometrium. She underwent a simple total abdominal hysterectomy, with a preoperative diagnosis of uterine liposarcoma. Histological examination revealed a uterine lipoleiomyoma. Ten days after surgery, she died due to acute non-occlusive mesenteric ischemia.
In cases where the radiological appearance of a uterine tumor in an elderly patient is suspicious for liposarcoma, the possibility of a benign lipoleiomyoma should be considered. Careful consideration of the patient's preoperative condition and familiarity with uterine fat-containing tumors are essential for determining an optimal therapeutic approach.
子宫脂肪平滑肌瘤是一种罕见的、含脂肪的良性肿瘤。该肿瘤的临床特征及最佳治疗方法尚不清楚。
一名有广泛心脏病史的80岁女性因评估巨大盆腔肿块而前来就诊。磁共振成像显示子宫肿瘤信号强度不均匀增高。脂肪抑制技术显示信号强度呈异质性抑制，注射钆喷酸葡胺（Gd-DTPA）后有强化增强区域。宫腔镜检查显示子宫内膜无异常发现。她接受了单纯全腹子宫切除术，术前诊断为子宫脂肪肉瘤。组织学检查显示为子宫脂肪平滑肌瘤。术后十天，她因急性非闭塞性肠系膜缺血死亡。
对于老年患者子宫肿瘤的影像学表现疑似脂肪肉瘤的病例，应考虑良性脂肪平滑肌瘤的可能性。仔细考虑患者的术前状况并熟悉含脂肪的子宫肿瘤对于确定最佳治疗方法至关重要。
