Erdem ŞAHİN, Yusuf MADENDAĞ, İlknur ÇÖL MADENDAĞ, Mehtap KALA, Ahter TAYYAR, Gökhan AÇMAZ

UTERIN LIPOLEIOMYOMA; OLGU SUNUMU

Uterin lipoleyomyomlar ultrasonda sıklıkla yanlış teşhis edilen nadir bening tümörlerdir, bu yüzden de onlar gereksiz invaziv tedavilere sebep olur. Klinik pratikte lipoleyomyomun iyi diferansiye liposarkomdan ayırımı önemlidir. Literatüre göre çok sayıda preoperatif iyi diferansiye liposarkom tanısı almış lipoleyomyom vakası mevcuttur. Liposarkomlar invaziv tedavi edilirken lipoleyomyomlar klinik ve radyolojik olarak takip edilebilirler. Bu yüzden bu hastaların cerrahiye maruz kalmadan doğru teşhis edilmesi çok önemlidir. Bizde burada nadir bir olgu olan 56 yaşında postmenapozal bir hastada teşhis edilen lipoleyomyom vakasının klinik bulguları, teşhisi ve tedavi prensiplerini günümüz literatürüne göre tartışıyoruz.

A Case Report: Uterine Lipoleiomyoma

Uterine lipoleiomyomas are rare benign tumors which are often misdiagnosed on ultrasound; therefore they are leading to unnecessary invasive procedures. In clinical practice, it is important to discriminate lipoleiomyoma from a liposarcoma. According to the literature there are a lot of cases of lipoleiomyoma diagnosed preoperatively as a well-differentiated liposarcoma. While liposarcomas must be operated, asymptomatic lipoleiomyomas can be followed clinically and radiologically. Thus it is important to diagnose accurately the patients before they are exposed to the surgery. We present a rare case of lipoleiomyoma that arose in the submocusal area of uterine fundus together with endometrial polyp and this patient's clinical findings, diagnosis and treatment principles are discussed in the current literature.

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1. Lin KC, Sheu BC, Huang SC. Lipoleiomyoma of the uterus. Int J Gynaecol Obstet. 1999; 67:47-9.
2. Rollasson TP, Wilkinson N. Non neoplastic conditions of myometrium and pure mesenchymal tumours of the uterus. In: Fox H, Wells M, editors. Haines and Taylor Obstetrical and gynaecological pathology. 5th ed. Edinburgh: Churchill Livingstone; 2003. p. 531.
3. Manjunatha HK, Ramaswamy AS, Kumar BS, Kumar SP, and Krishna L, "Lipoleiomyoma of uterus in a postmenopausal woman,"Journal of Mid-Life Health,vol.1,no.2, pp.86-88,2010.
4. Akbulut et al. Lipoleiomyoma of the Uterus Balkan Med J, Vol. 31, No. 3, 2014
5. Sudhamani S, Agrawal D, Pandit A and Kiri VM, "Lipoleiomyoma of uterus: a case report with review of literature,"Indian Journal of Pathology and Microbiology,2010;53:840-841-4.
6. Scurry JP, Carey MP, Targett CS, Dowling JP. Soft tissue Lipoleiomyoma. Pathology. 1991;23:360-2.
7. Kondi-Pafiti A,Grapsa D,Kairi-Vassilatou E, Kontogianni -Katsarou K, Koliopoulos C, Botsis D. Mesenchymal tumors of the uterine corpus with heterologous and hematopoietic components: a study of ten cases and review of the literature. Eur J Gynaecol Oncol 2006; 27:73-7.
8. Sieinski W. Lipomatous neometaplasia of the uterus: report of 11 cases with discussion of histogenesis and pathogenesis. Int J Gynecol Pathol 1989; 8:357-63
9. Demopoulos RI, Denervaes F, Kajı V. Benign mixt mesodermal tumors of the uterus: A histogenetic study. Am J Clin Pathol 1973;60:377-383
10. Kovacs J, Poka R. Lipoma of uterus. Pathology Research 1996;2:181-183
11. Zaloudek C, Hendrickson M R. Mesencymal tumors of the uterus. Chapter 13. In Blaustein's Pathology of the Female Genital Track, ed Robert J. Kurman, Springer-Verlag New York, Inc. 2002;5th ed.pp:561-615
12. Wang X, Kumar D,Seidman JD. Uterine lipoleiomyomas: A clinicopathologic study of 50 cases.Int J Gynecol Pathol 2006;25:239-42.
13. Ghosh B, McKeown B and Gumma A, "Lipoleiomyoma,"BMJ Case Reports, vol. 2011, Article ID bcr0820114577, 2011.
14. Resta L, Maiorano E, Piscitelli D, Botticella MA. Lipomatous tumors of the uterus clinico- pathological features of 10 cases with immunocytochemical study of histogenesis. Pathol Res Pract 1994;190:378-83.
15. Maebayashi T, Imai K, Takekawa Y, et al. Radiologic features of uterine lipoleiomyoma. J Comput Assist Tomogr 2003; 27:162-5.
16. Bell SW, Kempson RL, Hendrickson MR. Problematic uterine smooth muscle neoplasms. A linicopathologic study of 213 cases. Am J Surg Pathol 1994;1535-58.
17. Aslan E, Kilicdag EB, Haydardedeoglu B, Yıldırım T. Lipoleiomyoma of the uterus: A diagnostic roblem. J Obstet Gynaecol 2005;25:610-1.
18. Scurry J, Hack M. Leiomyosarcoma arising in alipoleiomyoma. Gynecol Oncol 1990; 39: 381-3.