We report a rare, simultaneous occurrence of benign metastasizing leiomyoma in the lung and retroperitoneum in a 49-year-old woman who had previously undergone myomectomy at 35 years of age and hysterectomy at 45 years of age for multiple recurrences of histologically benign uterine leiomyomas. At 49 years of age, computed tomography-guided biopsy indicated benign metastasizing leiomyomas in the lung. In addition, a retroperitoneal leiomyoma was found that was resected along with both the ovaries via laparotomy. No sign or symptom of recurrence was observed 5 years later. The coexistence of benign metastasizing leiomyoma in the lung and retroperitoneum following surgery for conventional leiomyomas has rarely been reported. Further, the nature and etiology of benign metastasizing leiomyoma are still not well understood. This case is therefore worth reporting, and exploring its etiology is important.

Objective:  Noninvasive evaluation must be required for deeply infiltrating endometriosis, typically accompanied by pelvic pain, dyspareunia, and bowel retraction. To explore noninvasive diagnostic methods for deeply infiltrating endometriosis, we employed a combination study of a diagnostic scoring system and transrectal ultrasonography. Methods:  A prospective diagnostic study was designed for deeply infiltrating endometriosis by noninvasive diagnostic scoring and transrectal ultrasonography (n = 40). Results:  Sixteen out of twenty‐four women with positive points in the diagnostic scoring had deeply infiltrating endometriosis on uterosacral ligaments. Uterosacral ligaments were thickened in 83.3% of patients with deeply infiltrating endometriosis on uterosacral ligaments. The patients who had both thickened uterosacral ligaments and a positive diagnostic score were limited to patients with deeply infiltrating endometriosis on uterosacral ligaments. Conclusion:  Our findings showed that thick uterosacral ligaments associated with a positive diagnostic score strongly designated that the women were affected by deeply infiltrating endometriosis. It is concluded that this combination study has clinical diagnostic value for deeply infiltrating endometriosis at the outpatient department. ACTA OBST GYNAEC JPN Vol. 54, No. 7, pp. 919–924, 2002