Leiomyomas beyond the uterus presenting with multiple growth patterns in a single patient

Uterine smooth muscle tumors are the most common diseases among uterine tumors, among which there are three types of uterine smooth muscle tumors with abnormal growth patterns: intravascular leiomyomatosis (IVL), benign metastasizing leiomyoma(BML), and disseminated peritoneal leiomyomatosis (DPL). Here, we present a case of a smooth muscle tumor with multiple abnormal growth patterns, discuss the development and treatment of the disease.

This article describes a 45-year-old woman who had a long history of dull lower abdominal pain. The medical history revealed that the patient had a history of previous laparoscopic myomectomy as well as a history of recurrent uterine fibroids. The patient underwent a total of three lesion removal surgeries at our institution: total hysterectomy and resection of an intestinal mass, resection of a right upper diaphragmatic mass and wedge resection of the right upper lung, and robotic-assisted laparoscopic resection of a right retroperitoneal mass. Multiple pathologies confirmed benign smooth muscle tumors. The patient did not choose hormone therapy after all three surgeries. The patient recovered well after surgery and was followed up regularly for four years without signs of recurrence.

This case illustrates that uterine leiomyomas can present with more than one extrauterine growth pattern. Accurate recognition and patient‑specific management are essential. Complete surgical excision can be considered in selected patients and may provide durable control.