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Pulmonary benign metastasizing leiomyoma: A case report
Malik Khan1, Annum Faisal2, Hussain Ibrahim1
1Grand Rapids Medical Education Partners/ Michigan State University, Grand Rapids, MI 49503, USA.
Respiratory Medicine Case Reports
|July 7, 2018
Summary
Benign metastasizing leiomyoma (BML) is a rare condition where uterine tumors spread to the lungs. This case highlights diagnosis and treatment of pulmonary BML after hysterectomy.
Area of Science:
- Gynecologic Oncology
- Pulmonary Medicine
- Pathology
Background:
- Uterine leiomyomas are common benign tumors, but rarely exhibit extra-uterine spread.
- Benign metastasizing leiomyoma (BML) is an uncommon pattern, with the lungs being the most frequent site of metastasis.
Observation:
- A 47-year-old female presented with shortness of breath and chest pain 3 years post-hysterectomy for uterine leiomyoma.
- Chest CT revealed multiple pulmonary nodules; PET/CT showed mild FDG uptake.
- CT-guided biopsy and subsequent wedge resection confirmed a low-grade smooth muscle tumor consistent with pulmonary BML.
Findings:
- Immunohistochemistry was positive for smooth muscle markers, estrogen, and progesterone receptors.
- Cytogenetic analysis supported the diagnosis of pulmonary BML.
- The patient underwent left lower lobe resection and initiated an aromatase inhibitor.
Implications:
- Pulmonary BML is rare, typically affecting women of reproductive age.
- Management and pathogenesis remain debated, but BML often follows an indolent course.
- This case underscores the importance of considering BML in patients with a history of uterine leiomyoma and unexplained pulmonary nodules.
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