Design: N/A

Setting: Academic Medical Center - The patient was a 26yo G2P0111 with a history of Wilms tumor and left ovarian fibrosarcoma who presented to the ED for irregular vaginal bleeding with associated increasing right lower quadrant pain. Transvaginal ultrasound demonstrated an incidental finding of an intramural mildly vascular echogenic myometrial mass most consistent with a lipoleiomyoma, which was consistent with the findings of a subsequent MRI. Due to history of two malignancies and desire for future fertility, the patient was taken to the OR for hysteroscopic resection of the lipoleiomyoma.

Patients or Participants: N/A

Interventions: Operative hysteroscopy with removal of lipoleiomyoma

Measurements and Main Results: N/A

Conclusion: Lipoleiomyomas are benign tumors with a prevalence of 0.03 to 0.2%, and few cases are reported in scientific literature. According to a systematic literature review conducted in 2022, only 16% of documented lipoleiomyoma resections are performed through myomectomy or simple excision, while 77% are removed via total hysterectomy. We propose that operative hysteroscopy should be considered as a safe and effective surgical intervention for excision of uterine lipoleiomyoma, that accounts for future fertility goals. We present this video aiming to enhance the understanding of surgical techniques associated with management of Lipoleiomyoma.