Timing for Minimally Invasive Surgery in Lipoleiomyoma: Insights From Two Cases

Lipoleiomyoma, a subtype of leiomyoma, may demonstrate hypertrophic growth, leading to tumor enlargement and presenting with clinical features such as postmenopausal bleeding and symptoms mimicking malignancy. These characteristics highlight the importance of careful evaluation and management in outpatient settings to ensure appropriate treatment. We report two cases of lipoleiomyoma with classical scenarios. The first case was initially misdiagnosed as an ovarian tumor and managed conservatively. Following tumor enlargement, laparoscopic surgery was performed after shared decision-making with the patient. The second case mimicked malignancy and was managed surgically via laparotomy. These cases highlight typical clinical scenarios of lipoleiomyoma. From our first case to April 2024, a review of 50 reported cases revealed that only 12 were managed using minimally invasive surgery (MIS) despite the benign nature of the condition and the widespread accessibility of this surgical approach. Upon diagnosis, providing patients with these characteristics and possible disease course and management strategies is crucial. A less invasive laparoscopic approach is safe and feasible when appropriate preoperative evaluation and meticulous surgical planning are conducted.