Incidental Benign Metastasizing Leiomyoma in a Patient with Bone Sarcoma: A Case Report

Real-Romo, Z.J. del; Montero-Cantú, Carlos Alberto; Villegas-Cabello, Oscar; Díaz-Elizondo, José Antonio; Reyes-Salas, Danae; Palomo-Hoil, Rene; Peralta-Castillo, Guillermo; Martínez-Sánchez, David; Flores‐Villalba, Eduardo

doi:10.1155/2014/439061

Cited by 4 publications

(5 citation statements)

References 6 publications

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“…In review study, microscopic examination of haematoxylin and eosin slides has demonstrated the characteristic features of smooth muscle cell differentiation, which was also confirmed by immunohistochemistry smooth muscle actin positivity.Additional immunohistochemistry Ki67 showed a low tumour cell proliferation index, which favors a benign behavior [ 3 , 4 , 7 , 8 , 11 – 14 , 17 , 18 , 20 – 22 , 27 , 31 – 37 , 41 – 55 ].…”

Section: Discussionmentioning

confidence: 99%

Benign metastasizing leiomyoma: A review of current literature in respect to the time and type of previous gynecological surgery

Książek²,

et al. 2017

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IntroductionBenign metastasizing leiomyoma (BML) is a rare disorder that affects women with a history of uterine leiomyoma, which is found to metastasise within extrauterine sites. The aetiology of BML remains unexplained. Because BML is rare, and most publications contain descriptions of single cases, no statistically determined time relations were found between the primary and secondary surgeries, which may have aetiological implications.ObjectivesTo determine age before BML surgery, age during diagnosis of BML, type of prior surgery, and location of metastasis based on the literature.MethodsA systematic review of four databases (Medline/PubMed, Embase, Web of Science, and Cochrane) covering articles published from 1 January 1965 to 10 April 2016. The inclusion criteria were full-text articles in English and articles containing case reports. Articles in languages other than English (39), articles containing incomplete data (14), i.e. no information regarding the time of surgery and/or the site of metastasis, articles bereft of case studies (25), and articles with access only to summaries, without access to the complete text (10) were excluded. Of 321 titles identified, only 126 articles met the aforementioned criteria.Results and conclusionsThe mean age during primary surgery and BML diagnosis was 38.5 years and 47.3 years, respectively. The most common surgery was total hysterectomy. The most frequent site of metastasis was the lungs; other organs were affected less frequently.The site of metastases and their number were not related to the longer time span between the patient’s initial surgery and occurrence of metastasis. The analysed data, such as the age during primary surgery, age during BML diagnosis, site and type of metastasis, do not provide us a clear answer. Thus, BML pathogenesis is most probably complex in nature and requires further multidirectional research.

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Section: Discussionmentioning

confidence: 99%

Benign metastasizing leiomyoma: A review of current literature in respect to the time and type of previous gynecological surgery

Książek²,

et al. 2017

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“…In the case we described, the myomectomy was the primary procedure – similar as in most other cases of BML. Other procedures, as described in articles, included a total or subtotal hysterectomy [ 9 , 15 – 19 ]. There were only 3 cases described where female patients were diagnosed with BML without any prior gynecological surgery [ 1 , 9 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…The second suggests that BML represents a low grade leiomyosarcoma. The third advocates a hematogenous dissemination of the primary lesion [ 9 , 15 – 18 ].…”

Section: Introductionmentioning

confidence: 99%

Benign metastasizing leiomyoma in triple location: lungs, parametria and appendix

Raś

Książek²,

Barnaś³

et al. 2016

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Benign metastasizing leiomyoma (BML) usually are situated in one organ, most often in lungs. BML patients typically have a history of uterine leiomyoma treated with hysterectomy, myomectomy or subtotal hysterectomy. The aim of the study was to present the case of a 53-year-old woman with triple location in the lungs, parametria and appendix. She had undergone a myomectomy 26 years earlier. In 2015, she was admitted to the surgical department because of abdominal pain, whereupon a cholecystectomy was performed. CT scans showed pelvic mass with pulmonary metastasis. Upon discharge the patient was referred to the Gynecology Clinic, where a laparotomy was performed. The intraoperative findings were: 1) uterus with multiple leiomyomas, 2) four tumors in the parametria, 3) tumor connected to the appendix. A subtotal hysterectomy, with a bilateral salpingo-oophorectomy, removal of the tumors from the parametria and appendectomy was performed. Pathology confirmed the diagnosis based on morphology and immunohistochemical staining (strongly positive for estrogen receptors and SMA, while Ki67 was very low, below 1%). Upon postoperative recovery, the patient was referred to the Thoracic Surgery Department. During the thoracotomy, multiple nodes, surrounded by lung parenchyma, were revealed. Wedge resection was performed, for localized pulmonary lesions, and sent for pathological examination. The final pathological diagnosis was benign metastasizing leiomyomatosis.In conclusion, the triple location of BML could possibly be a result of a parallel different metastasizing mechanism, although it is impossible to exclude one mechanism, which may be the cause of the metastases in three locations.

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“…The clinical presentation of BML depends largely on its site of involvement, of which the lung is most frequent. BML involving the lung is usually asymptomatic and found incidentally on imaging, such as during staging workup for unrelated malignancies [ 4 ]. The nodules are usually found after hysterectomy or after myomectomy at durations of 3 months to 20 years [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

An Unusual Cause of Pulmonary Nodules in the Emergency Department

Ferri

2015

Case Reports in Emergency Medicine

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We report a 51-year-old woman who presented to the emergency department with left-sided pleuritic chest pain 2 weeks after subtotal hysterectomy and bilateral salpingo-oophorectomy for a leiomyomatous uterus. Computed tomography scan of the chest revealed bilateral pulmonary nodules. Biopsy showed cytologically bland spindle cells without overt malignant features. Immunohistochemistry confirmed smooth muscle phenotype, in keeping with a clinicopathologic diagnosis of benign metastasizing leiomyoma (BML). BML does not frequently come to the attention of the emergency physician because it is rare and usually asymptomatic. When symptomatic, its clinical presentation depends on the site(s) of metastasis, number, and size of the smooth muscle tumors. Emergent presentations of BML are reviewed.

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Incidental Benign Metastasizing Leiomyoma in a Patient with Bone Sarcoma: A Case Report

Cited by 4 publications

References 6 publications

Benign metastasizing leiomyoma: A review of current literature in respect to the time and type of previous gynecological surgery

Benign metastasizing leiomyoma: A review of current literature in respect to the time and type of previous gynecological surgery

Benign metastasizing leiomyoma in triple location: lungs, parametria and appendix

An Unusual Cause of Pulmonary Nodules in the Emergency Department

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