Ryan Schwope
CT shows a predominantly fat
attenuation, intramural uterine mass. There is rim of surrounding
calcification as well as a few foci of internal soft tissue density at the
superior aspect of the mass 

Ryan Schwope
   MR imaging showed the majority of the uterine mass as hyperintense on T1 weighted imaging (isointense to subcutaneous

Ryan Schwope
T2 weighted image with fat saturation MRI shows the uterine mass markedly hypointense (isointense to subcutaneous fat)

Ryan Schwope
Post contrast T1 weighted MRI image with fat saturation show mld enhancement of the soft tissue component  along the superior margin of the mass; the majority of the mass is markedly hypointense (isointense to subcutaneous fat)

lipoleiomyomas are rare, benign tumors with a variable reported incidence
ranging from 0.03% to 0.2%. The exact etiology of these lesions is
unclear.  It is postulated lipoleiomyomas
either arise from fatty metaplasia of the smooth muscle cells of leiomyomas, or
from misplaced embryonic fat cells in the uterus. CT is highly specific for
the diagnosis when an intrauterine mass is seen containing both macroscopic fat
and soft tissue density. MR can also be confirmatory as the mass will have high
T1 weighted signal which can be confirmed as fat by using a fat suppression. The role of imaging is also to differentiate lipoleiomyoma from an ovarian
teratoma, a much more common entity presenting as a fat-containing pelvic mass.
Lipoleiomyomas require no treatment or follow-up whereas teratomas are
frequently resected.