Clinical, Radiological, and Histopathological Analysis of Lipoleiomyoma: A Retrospective Study From a Tertiary Care Center

Introduction Uterine leiomyoma is a benign smooth muscle tumor commonly occurring in women of reproductive age and showing a myriad of morphologies. Variants account for a minority of these tumors. Lipoleiomyoma is a rare variant of leiomyoma composed of mature adipose tissue intricately interspersed within smooth muscle proliferation. This benign neoplasm has shown a proclivity toward perimenopausal and menopausal obese women. Despite its benign nature, clinical gumption is necessary, as its presence may herald coexistent gynecological pathologies, both benign and malignant. Methodology This is a retrospective study of 18 patients with histopathologically diagnosed lipoleiomyoma over a five-year period, from January 2021 to December 2025. Retrospective microscopic evaluation was performed on 10% formalin-fixed hysterectomy or myomectomy specimens, along with the acquisition of clinical, radiological, and gross details from patients' records. Results A total of 18 patients included in the study varied in age from 25 to 72 years. Of these, 14 were within the perimenopausal age group, whilst two patients were within the reproductive age group. Clinical presentation varied from abnormal uterine bleeding to mass descending per vagina. A few lipoleiomyomas were incidentally detected during evaluation of adnexal cysts. Notably, 10 out of 18 patients were diabetic, whilst four had impaired glucose tolerance. Radiological assessment favored leiomyoma in most cases, whilst a few were reported to have hyperechoic or lipomatous components on ultrasound. Histopathological evaluation of the resected specimens uncovered other coexisting benign and malignant gynecological conditions, such as adenomyosis, endometrial polyp, and cervical adenocarcinoma, respectively. Conclusion Given these associations, it is imperative to carefully evaluate patients clinically and pathologically for coexisting gynecological conditions, both benign and malignant, along with metabolic disorders when lipoleiomyoma is detected. This helps avoid the delayed discovery of potentially morbid and fatal diseases.