Pulmonary benign metastasizing leiomyoma from uterine leiomyoma

Abstract

BackgroundBenign metastasizing leiomyoma (BML) occurs in a low proportion of uterine leiomyomas and treatment methods for BML are diverse and controversial. The study introduces preliminary experiences in the diagnosis and treatment of BML with the purpose of finding a suitable management strategy for these patients.MethodsThree patients with BML were treated in our department from April 2008 to July 2012. Each of these patients presented with multiple nodules in both lungs, where we performed video-assisted thoracoscopic wedge resection to harvest enough tissue for histopathologic and immunohistochemical examination. The patients were treated with medical castration or surgical castration after the diagnosis of BML.ResultsThe ultimate pathologic results ruled out the possibility of leiomyosarcoma and other metastatic diseases, and confirmed that the pulmonary lesions were BML. The lung lesions remained stable in two patients who were treated by surgical castration, and the lung nodules regressed in one patient treated with gonadotropin-releasing hormone analogues.ConclusionsThe diagnosis of BML is based on the medical history of uterine myomas and histopathologic and immunohistochemical examination of lung nodules. Video-assisted thoracoscopic wedge resection is the best way to harvest tissue for diagnosis. The better outcomes in BML seem to call for medical intervention, either chemical or surgical, after diagnosis is made.

Leiomyomas beyond the uterus; benign metastasizing leiomyomatosis with paraaortic metastasizing endometriosis and intravenous leiomyomatosis: a case series and review of the literature

“…Hormonal treatment can be a therapeutic option for young women who desire to retain fertility and for whom oophorectomy is not an option [35]. However, the primary treatment has been advocated to be a radical surgical resection [3,36]. Depending on locations of the metastases and the hormone receptor status, treatment should be individualized for each patient.…”

Benign metastasizing leiomyoma of the lung: A case report and literature review

“…Although the biological behavior of BML suggested malignancy, the tumor is borderline, with benign histological features. A previous stuy demonstrated that the lungs are the most common site of metastases (6). Pulmonary BML may present as asymptomatic pulmonary nodules diagnosed incidentally, be synchronous with uterine leiomyomas or arise following hysterectomy.…”

Case of concurrent benign metastasizing leiomyoma in the lung and retroperitoneum, with a focus on its etiology

“…Before making a diagnosis of BML, leiomyosarcoma or smooth muscle tumors of uncertain malignant potential must be excluded. In most cases, the morphological features and immunohistochemistry should be sufficient for identification, however, the final diagnosis of BML should only be made after a careful review of a substantial number of samples obtained from the primary legion to exclude even small foci of aggressive leiomyosarcoma …”