Sonographic evaluation of a uterine angiolipoleiomyoma

We report the case of a 51-year-old postmenopausal woman with an angiolipoleiomyoma, a rare mesenchymal uterine tumor, and describe its sonographic appearance. The clinical presentation of these invariably benign tumors often mimics that of uterine leiomyomas, making angiolipoleiomyomas difficult to diagnose correctly before histopathologic evaluation. In this case, sonography performed to determine the cause of the patient's vaginal bleeding showed a sharply marginated, brightly echogenic solid mass adjacent to the echogenic endometrium, without associated shadowing. Histopathologic examination revealed that this tumor was composed of smooth muscle, adipose tissue, fibrous connective tissue, and blood vessels. These sonographic findings, which are unusual for tumors of the uterus, suggest the diagnosis of angiolipoleiomyoma. Accurate diagnosis of these benign tumors could prevent patients from undergoing surgery and would allow appropriate counseling of patients.