Angiolipoleiomyoma of the Uterus: A rare case report and review of the literature

Abstract

The aim of this study is to present a case of angiolipoleiomyoma (ALLM), a rare benign tumor of the uterus, compare it with similar cases in the literature, and contribute to the diagnosis, treatment, and classification process of this tumor.A 40-year-old diabetic woman, gravida 4 para 4, presented to the emergency department with prolonged vaginal bleeding accompanied by dull lower abdominal pain. On admission, her hemoglobin level was 6.8 g/dL and hematocrit were 23.9%. Gynecological examination revealed a relaxed abdomen and a semi-mobile, non-tender fullness in the right adnexal region on bimanual palpation.Further history indicated that the patient had been experiencing prolonged abnormal uterine bleeding as the primary symptom, with the dull pain emerging more recently. Following urgent blood transfusion, pelvic ultrasonography revealed a heterogeneous, hyperechoic cystic-solid mass located on the right side of the uterus.Pelvic magnetic resonance imaging (MRI) showed a lobulated mass measuring 90×52 mm, slightly hyperintense on T1-weighted sequences, and demonstrating heterogeneous enhancement after contrast administration.The mass was surgically removed via a Pfannenstiel incision. Histopathological examination confirmed the diagnosis of ALLM.A comprehensive literature search was conducted using the keyword \"angiolipoleiomyoma\" in PubMed and Google Scholar up to June 2024. Animal studies were excluded from the review. As a result, 31 cases were identified, and diagnoses and classifications were evaluated according to the most recent histopathological criteria.ALLM is a rare, typically asymptomatic, and benign tumor of the uterus. Definitive diagnosis is made through histopathological examination. The information from the literature and the presented case highlights the diagnostic characteristics of this tumor and contributes to future classification studies.Note: This study was presented as a poster at the 15th Turkish-German Gynecology Congress, held on April 23–27, 2025, at Rixos Sungate, Antalya, Türkiye.