Rare uterine tumor mimicking malignancy highlights importance of accurate diagnosis

A new case report was published in Volume 12 of Oncoscience on July 2, 2025, titled "Navigating diagnostic complexity: A case report on uterine lipoleiomyoma, unveiling its benign nature amidst characteristics resembling liposarcoma."

In this report, Seetu Palo, first corresponding author Mishu Mangla and colleagues from the All India Institute of Medical Sciences describe a rare case where a benign uterine tumor closely resembles a malignant tumor in an elderly patient. Their findings emphasize the importance of careful diagnosis in post-menopausal women with fibroid-like symptoms to avoid unnecessary aggressive treatments.

Lipoleiomyomas are uncommon benign tumors in the uterus made up of smooth muscle and fat cells. One such tumor was identified in a 75-year-old woman, 25 years post-menopause, who presented with persistent lower abdominal pain. Imaging revealed two fibroid-like masses, and surgery confirmed features of lipoleiomyoma. Detailed microscopic analysis established the benign nature of the tumors despite their initial resemblance to malignant liposarcoma.

Accounting for only 0.03–2.1% of all uterine fibroids, these rare tumors usually appear in post-menopausal women. The patient in this report also had diabetes and hypertension, supporting the theory that metabolic changes after menopause may contribute to their development.

The authors also point to the fact that light microscopy remains the gold standard for distinguishing lipoleiomyomas from malignant counterparts. Imaging techniques such as MRI may not detect fat components in smaller lesions, which can complicate diagnosis and increase the risk of misinterpretation.

By documenting this unusual case, the team aims to raise awareness among healthcare professionals about this rare condition. Greater vigilance in histopathological evaluation can prevent misdiagnosis and reduce the likelihood of unnecessary interventions. This case report also adds knowledge to the limited literature on lipoleiomyomas and recommends a careful assessment when such tumors are suspected in elderly patients.