Article

Benign abdominal and pulmonary metastasizing leiomyoma of the uterus.

Department of General Surgery and Thoracic Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 7, Kiel 24105, Germany.
Archives of Gynecology and Obstetrics (impact factor: 1.28). 09/2006; 274(5):319-22. DOI:10.1007/s00404-006-0165-8 pp.319-22
Source: PubMed

ABSTRACT Benign metastasizing leiomyoma (BML) is a rare disease in which the lung is described to be the most afflicted extrauterine organ.
We report of a 42-year-old African woman with a BML in the abdomen and lung who had undergone a hysterectomy for uterine leiomyoma 10 years ago. She was admitted to our hospital for investigation of a huge tumor mass in the pelvis consisting of multiple nodules in the abdomen and left lung. Assuming an advanced intraperitoneal malignancy was present, a 'palliative' limited tumor debulking and due to a tumor compressing the sigmoid a Hartmann's procedure was performed.
The histopathologic examination showed a leiomyoma positive for estrogen receptor. Treatment was started with GnRH analoga. In the presence of a stable disease after 12 months, the patient underwent a re-laparotomy with a reanastomosis of the colon. Treatment was continued with GnRH analoga and the residual nodules have not increased in size during 36 months of follow-up.
The review of the literature supports the concept that the primary tumor of BML is located in the uterus and that leiomyomas in the uterus can metastasize leading via hematogenous spread to BML. However, the origin of the tumor remains controversial.

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    Article: Benign metastasizing leiomyoma with multiple lymph node metastasis: a case report.
    Gun Yoon, Tae-Joong Kim, Chang-Ohk Sung, Chel Hun Choi, Jeong-Won Lee, Je-Ho Lee, Duk-Soo Bae, Byoung-Gie Kim
    [show abstract] [hide abstract]
    ABSTRACT: This is a case report about benign metastasizing leiomyoma with multiple lymph node metastasis. A 34-year-old woman received an abdominal myomectomy for a suspicious leiomyoma. On the pathology report, atypical leiomyoma was suspected. Due to the suspicion of multiple lymph node metastasis on pelvis computed tomography (CT) 1 year after the operation, she was transferred to the Samsung Medical Center on October, 2009 for further work up. According to original slide review, it was determined to be a benign leiomyoma with a mitotic count <5/10 high-power fields, little cytological atypia and no tumor cell necrosis. Additional immunostaining was done. Multiple lymph node metastasis and a small lung nodule were identified on positron emission tomography-CT [corrected] and chest CT. Extensive debulking surgery and diagnostic video-assisted thoracoscopic surgery (VATS) wedge resection were subsequently done. Metastatic lesions were reported to have a histology similar to that of the original mass. VATS right upper lobectomy with mediastinal lymph node dissection was performed because of the pathology result of VATS (adenocarcinoma). She started taking an aromatase inhibitor (Letrozole®) and there was no evidence of recurrence of disease on an imaging study and no post-operative complications until recently.
    Cancer Research and Treatment 06/2011; 43(2):131-3.
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Keywords

'palliative' limited tumor debulking
 
36 months
 
42-year-old African woman
 
advanced intraperitoneal malignancy
 
afflicted extrauterine organ
 
Benign metastasizing leiomyoma
 
BML
 
GnRH analoga
 
Hartmann's procedure
 
hematogenous spread
 
histopathologic examination
 
huge tumor mass
 
hysterectomy
 
leiomyoma positive
 
multiple nodules
 
primary tumor
 
residual nodules
 
stable disease
 
tumor compressing
 
uterine leiomyoma 10 years
 

Jan-Hendrik Egberts