Pure Uterine Lipoma: A Report of a Rare Entity

Abnormal genital tract bleeding is a commonly encountered complaint in general practice. It has a wide range of etiologies and the spectrum depends on the reproductive status of the patient. While it represents a small proportion of genital tract bleeding, endometrial carcinoma is the main concern in postmenopausal women with abnormal genital bleeding. However, the majority of cases are due to benign etiologies. We present the case of a 65-year-old woman who presented to the outpatient department complaining of vaginal bleeding and lower abdominal pain for the last two months. The patient did not report any use of hormonal replacement therapy. Her last Pap smear was five years ago and it yielded no abnormal cells. On examination, the patient appeared obese with a body mass index of 35 kg/m². Abdominal examination revealed a palpable pelvic mass that was firm and non-tender. The patient underwent an abdominal computed tomography scan which demonstrated a well-defined oval-shaped homogeneous fat attenuation mass lesion within the uterine wall with no evidence of invasion. Such findings were suggestive of uterine lipoma. The patient underwent a total hysterectomy and bilateral salpingo-oophorectomy. Histopathological examination of the specimen confirmed the diagnosis of pure lipoma. After six months of close follow-up, the patient had no active complaints. Pure uterine lipoma is an exceedingly rare benign neoplasm of the uterus. It may present with an abdominal mass and abnormal genital bleeding. Awareness of the clinical and radiological features of this tumor is crucial to avoid unnecessary surgeries in asymptomatic patients.