Giant Subserosal Lipoleiomyomas of the Uterine Cervix and Corpus: A Report of 2 Cases

Giant lipoleiomyoma (LL) of the uterus is a rare condition. The author reports herein 2 giant LL. The age of the patients was 47 and 66 years. One patient had large LL measuring 10 x 9 x 9 cm located in the subserosa in the uterine cervix. Another patient had giant LL measuring 30 x 30 x 30 cm in the subserosa of the uterine body. Grossly, the LL showed yellowish white color. Microscopically, both the tumors were composed of mature smooth muscle cells and mature lipocytes. Immunohistochemically, both cases showed the same immunohistochemical findings. The adipose tissue element was positive for vimentin, S100 protein, estrogen receptor (ER), and progesterone receptor (PgR); and negative for pancytokeratins (AE1/3 and CAM5.2), alpha-smooth muscle actin, desmin, HMB45, p53, MDM2, and CDK4. The smooth muscle element was positive for vimentin, desmin, alpha-smooth muscle actin, ER, and PgR, but negative for pancytokeratins (AE1/3 and CAM5.2), S100 protein, HMB45, p53, MDM2, and CDK4. The Ki-67 labeling was 0.3% in the smooth muscle element and 0.2% in the adipose tissue element in 1 case, and 0.2% and 0.1%, respectively, in another case. In conclusions, 2 cases of subserosal giant LLs of the cervix and body were reported. The main findings were that the adipose tissue element of LL shows cell proliferative activity and that it is positive for ER and PgR. The positive cell proliferation shows that the adipose element of LL was not degenerative tissue but actively proliferative tissue. The presence of ER and PgR in the adipose element suggests that the adipose element of LL was specific fat tissue related to female genital organs.