Benign Metastasizing Leiomyoma

Abramson, Simeon; Gilkeson, Robert C.; Goldstein, Jeffrey; Woodard, Pamela K.; Eisenberg, Rosana; Abramson, Neil

doi:10.2214/ajr.176.6.1761409

Cited by 155 publications

(52 citation statements)

References 9 publications

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“…They can vary in size from millimeters to centimeters and be randomly distributed in the lung parenchyma. ( 3 , 4 ) A solitary nodule, as seen in our patient, is a very rare presentation of BML. In general, pulmonary nodules do not calcify and can remain unchanged or even regress spontaneously.…”

Section: To the Editorsupporting

confidence: 55%

“…It has been suggested that smooth muscle cells spread to the lungs after uterine extension into pelvic venous channels; that tumors gain venous access from surgical trauma during hysterectomy; and that the lesions represent metastatic foci arising from low-grade leiomyosarcomas. ( 3 , 4 ) …”

Section: To the Editormentioning

confidence: 99%

“…Both CT and magnetic resonance imaging can be used in order to characterize pulmonary nodules in patients with BML; such nodules have a nonspecific appearance and usually show homogeneous contrast enhancement. ( 3 , 5 ) The efficacy of 18F-fluorodeoxyglucose positron emission tomography with CT (FDG-PET/CT) in detecting uterine leiomyomas is controversial. In the few reports available in the literature, FDG-PET/CT was unable to detect BML.…”

Section: To the Editormentioning

confidence: 99%

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Solitary benign metastasizing leiomyoma: imaging features and pathological findings

et al. 2014

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Section: To the Editorsupporting

confidence: 55%

Section: To the Editormentioning

confidence: 99%

Section: To the Editormentioning

confidence: 99%

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Solitary benign metastasizing leiomyoma: imaging features and pathological findings

et al. 2014

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“…BML foci may be detected from 3 months to even 30 years after hysterectomy or myomectomy [8,9]. The lungs are the main site of involvement; BML is mostly manifested as multiple, well-circumscribed, www.journals.viamedica.pl non-calcified nodules with poor contrast enhancement, but a miliary pattern has also been reported [10].…”

Section: Discussionmentioning

confidence: 99%

Metastasising Leiomyoma of the Uterus with Pulmonary Involvement—Case Report

Maskey-Warzęchowska

Chojnowska

Ptaszyński

et al. 2017

Advances in Respiratory Medicine

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Benign metastasising leiomyoma (BML) is characterised by extrauterine smooth muscle tumours in women after surgical treatment for uterine leiomyoma. Usually manifested as solitary or multiple focal lesions in various organs, it imposes a scrutinous diagnostic work-up to exclude a malignant disease and requires confirmation in microscopic examination of the extrauterine focus. The authors present a case of a 56-year-old woman with BML manifesting as bilateral multiple pulmonary nodules, with a tentative diagnosis of a disseminated malignant disease of mesenchymal origin. The patient underwent multiple diagnostic tests, which excluded malignancy. The definite diagnosis was established after the microscopic reevaluation of an excised pulmonary nodule. The patient is monitored with chest magnetic resonance. BML should be considered in the differential diagnosis of multiple pulmonary nodules in asymptomatic women. Patients with BML require long-term monitoring, therefore the selected imaging method should not carry the risk of cumulative side effects.

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“…11 Previous patients with BML similarly had antecedent CL. 14,17-22 Thus, CL and BML may share a common pathogenic mechanism and may even be different manifestations of the same disease. 11 …”

Section: Commentmentioning

confidence: 99%

Uterine cellular leiomyomata with chromosome 1p deletions represent a distinct entity

Hodge¹,

Pearce²,

Clayton³

et al. 2014

American Journal of Obstetrics and Gynecology

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OBJECTIVE This study aims to determine whether 1p deletion defines a subset of cellular leiomyomata (CL), a hypercellular variant of uterine leiomyomata (UL) that may have delayed malignant potential, and correlate this genetic change with clinical and pathologic characteristics including those present in uterine sarcomas. STUDY DESIGN Available CL cases at Mayo Clinic (n=101) and variant cases reported by Giuntoli et al. (n=16) were identified. Each case with sufficient tissue that met histologic criteria for CL when reviewed by a single pathologist underwent interphase FISH to determine the presence of 1p deletion. Clinical characteristics of women with confirmed CL were compared on the basis of 1p deletion status using univariate analysis. RESULTS Of the Mayo cohort of histologically confirmed CL, 23% had deletion of 1p. Women with this subset of CL when compared to those without 1p deletion were more likely to be postmenopausal (P=0.049) and their uteri tended to be heavier (P=0.039) with a larger dominant leiomyoma (P=0.030). The pathological features associated with 1p deletion were high cellularity (P=0.036) and hyaline necrosis (P=0.047), which remained significant after inclusion of the CL cases from the Giuntoli et al. series. CONCLUSION Deletion of 1p occurs in approximately one-quarter of CL. This genetic alteration is potentially associated with clinicopathologic features present in uterine sarcomas, suggesting a distinct clinical entity that may have malignant potential. Our findings are particularly pertinent considering the increased preference for uterine-sparing options in leiomyoma treatment, suggesting assessment of 1p deletion status in CL may influence clinical surveillance decisions.

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Benign Metastasizing Leiomyoma

Abstract: Benign metastasizing leiomyoma is an asymptomatic disease characterized by well-defined, numerous, pulmonary lesions without a preponderant distribution.

Cited by 155 publications

References 9 publications

Solitary benign metastasizing leiomyoma: imaging features and pathological findings

Solitary benign metastasizing leiomyoma: imaging features and pathological findings

Metastasising Leiomyoma of the Uterus with Pulmonary Involvement—Case Report

Uterine cellular leiomyomata with chromosome 1p deletions represent a distinct entity

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