LAUSR

A 65yearold postmenopausal woman presented with symptoms of uterine prolapse. The patient also complained of a single episode of bleeding that lasted for 5 to 6 days. She had grade IV prolapse for which she underwent vaginal hysterectomy. Grossly, the uterus measured 8.5×4×2.5 cm with an elongated and hypertrophied cervix (Figure 1A). On serial sectioning, an intramural nodule was identified in the right side of fundus measuring 2×1.5×1.2 cm (Figure 1B). It was wellcircumscribed and homogeneous with a tanyellow color. It was relatively soft in consistency. There were no areas of hemorrhage or necrosis identified. On microscopic examination, there was interlacing fascicles of smooth muscle cells with tapered ends, uniformly dispersed chromatin, a moderate amount of eosinophilic cytoplasm and inconspicuous nucleoli admixed with a varying number of evenly distributed mature adipocytes in a delicate vascular pattern (Figure 2A–C). There was no evidence of excess mitosis, necrosis, or nuclear atypia in sections examined. Immunohistochemistry, smooth muscle actin highlighted the smooth muscle cells (Figure 2D) confirming a diagnosis of lipoleiomyoma. Lipomatous lesions of the uterus are uncommon and are categorized broadly into three groups. Pure lipomas are composed of mature adipose tissue. The second category includes neoplasms containing mature adipose tissue with varying amounts of mesodermal component and includes lipoleiomyoma, fibromyolipoma, and