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

Area of Science:

• Gynecology
• Surgical Oncology
• Pathology

Background:

• Uterine smooth muscle tumors are common, with intravascular leiomyomatosis (IVL), benign metastasizing leiomyoma (BML), and disseminated peritoneal leiomyomatosis (DPL) representing unusual growth patterns.
• This case highlights a rare instance of a uterine smooth muscle tumor presenting with multiple simultaneous abnormal growth patterns.

Purpose of the Study:

• To present a unique case of uterine leiomyoma with multiple extrauterine growth patterns.
• To discuss the clinical presentation, management, and long-term outcomes of such complex cases.

Main Methods:

• A case report of a 45-year-old woman with a history of recurrent uterine fibroids and prior myomectomy.
• Description of three surgical interventions: hysterectomy with intestinal mass resection, diaphragmatic and lung mass resection, and retroperitoneal mass resection.
• Pathological confirmation of benign smooth muscle tumors and assessment of treatment outcomes.

Main Results:

• The patient underwent multiple complex surgeries for widespread benign smooth muscle tumors.
• Despite the aggressive presentation, the patient experienced a favorable outcome with no recurrence over a four-year follow-up period after surgical management.
• Hormone therapy was declined by the patient post-operatively.

Conclusions:

• Uterine leiomyomas can manifest with diverse and multiple extrauterine growth patterns.
• Accurate diagnosis and individualized treatment strategies are crucial for managing these complex cases.
• Complete surgical excision is a viable option for achieving long-term disease control in select patients.