Pulmonary Benign Metastasizing Leiomyoma: An Extremely Rare Case

Area of Science:

• Gynecologic Oncology
• Pulmonary Medicine
• Pathology

Background:

• Benign metastasizing leiomyoma (BML) is a rare condition characterized by the proliferation of smooth muscle tissue.
• It typically affects premenopausal women, often years after uterine leiomyoma or hysterectomy.
• BML commonly presents as bilateral pulmonary nodules, often incidentally discovered.

Purpose of the Study:

• To report a rare case of benign metastasizing leiomyoma presenting with backache and pulmonary nodules.
• To emphasize the diagnostic challenges and clinical presentation of BML.
• To discuss the potential pathogenesis of this condition.

Main Methods:

• Case presentation of a 44-year-old female with a history of uterine leiomyoma.
• Diagnostic imaging including computed tomography (CT) and positron emission tomography-computed tomography (PET-CT).
• Confirmation of diagnosis via open wedge biopsy of the lung.

Main Results:

• Computed tomography revealed multiple bilateral pulmonary nodules, the largest measuring 15 mm.
• PET-CT showed increased metabolic activity in the nodules (SUVmax: 1.92).
• Open wedge biopsy confirmed the diagnosis of benign metastasizing leiomyoma.

Conclusions:

• Benign metastasizing leiomyoma can present with atypical symptoms such as backache.
• Multimodality imaging is crucial for the diagnosis of pulmonary nodules in suspected BML.
• Surgical biopsy remains essential for definitive diagnosis of BML.