Benign metastasising leiomyoma after hysterectomy and bilateral salpingo-oophorectomy (original) (raw)
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Recurrent benign metastasizing leiomyoma after hysterectomy and bilateral salpingo-oophorectomy
Archives of Gynecology and Obstetrics, 2008
Background Benign uterine leiomyomas are sometimes found in association with benign smooth muscle tumors outside the conWnes of the uterus and are given the name benign metastasizing leiomyomas (BML). We present two patients who were on estrogen replacement therapy, in which BML recurred twice despite previous hysterectomy and bilateral salpingo-oophorectomy (TAH/BSO) requiring two additional laparotomies. Patients Our patients, presented with multiple abdominal masses 6 years after their initial surgery for benign leiomyoma. At exploratory laparotomy multiple benign leiomyomas were resected, and in one case a 2.2 cm leiomyoma was also resected from the left lower lobe of the lung. Both patients had a third laparotomy for another abdominal recurrence approximately 2 years later. Results Pathology revealed benign leiomyomas with no cytological atypia and a mitotic count of <5 per 10 high power Welds (hpf). Conclusion Benign metastasizing leiomyoma rarely follow TAH/BSO in patients with uterine myoma and estrogen replacement therapy may play a role in such occurrence. Despite surgery to remove these tumors, they can still recur; therefore, there is need for prolonged surveillance in such patients after resection.
Locally relapsed and metastatic uterine leiomyoma: A case report
Journal of Medical Case Reports, 2008
Introduction: Benign metastasising leiomyoma refers to a type of lesion characterised by leiomyomatous alterations without any indication of malignancy. It presents as either a singular nodule or multiple nodules of proliferating smooth muscle cells and is generally found in the lungs of women who have undergone a hysterectomy. The purpose of this case report is to contribute to the knowledge of this rare disease by presenting evidence and experience of a patient case. In particular, this report seeks to investigate the therapeutic approaches in order to understand whether a standard of care can be prescribed and whether the use of prophylaxis therapy with progesterone as a follow-up to surgery serves as a reasonable treatment in certain cases diagnosed as benign metastasising leiomyoma.
Pulmonary Benign Metastasizing Leiomyoma from the Uterus in a Postmenopausal Woman: Report of a Case
Surgery Today, 2004
Benign Metastatic Leiomyoma (BML) is a disease that stems from pulmonary smooth muscles and it is generally observed in multiple locations, including uterine leiomyomas. Apart from lungs it has been reported in lymph nodes, peritoneum, myocardium, eye, brain and spinal cord. We report a case of pulmonary BML from the uterus in a 50-year-old woman. Multiple nodules were identified in the lung fields by computed chest tomography of the patient, who presented with hemoptysis for 2 months. Endobronchial lesion was not observed by bronchoscopy. Cytopathological and immunocytochemical results confirmed the diagnosis of leiomyoma after the exploratory thoractomy. She had undergone hysterectomy with oophorectomy for uterine leiomyoma 5 years earlier, at the age of 45. Primary origin was from the uterus because hysterectomy and oophorectomy were performed 5 years ago for the leiomyoma. We present this case because it is a rare entity.
BMC Research Notes
Background: The occurrence of lung metastasis from benign uterine leiomyomas is rarely reported especially in post menopausal women. The pathogenesis of these metastatic benign tumors still remains a subject of various speculations. Case presentation: A 57-year-old woman presented with a chronic cough and dyspnea. She had undergone 8 years previously, hysterectomy for benign leiomyomas. A chest computed tomography scan showed a 4 cm solitary nodular parenchymal tumor that increased in size after 12 months. The histological analysis of the biopsy from this nodule showed a benign tumor with regular spindle cells disposed in intersected fascicles. At immunohistochemical analysis, the tumor cells were positive for smooth muscle markers and oestrogen-progesterone receptors with a low mitotic index assessed by Ki-67. These features were consistent with a benign metastasizing uterine leiomyoma. At the multidisciplinary meeting, prescription of an aromatase inhibitor has been decided for the patient. Conclusions: Benign metastasizing uterine leiomyomas of the lung are very rare tumors. Although extremely rare in post menopausal women, their diagnosis should be considered in symptomatic patients with a history of hysterectomy for leiomyomas.
Connecticut medicine, 2015
This paper will present a case of benign metastasizing leiomyoma, incidentally found during the preoperative evaluation for acute cholecystitis. The preoperative chest X-ray revealed diffuse bilateral lung nodules suspicious for hematogenous metastasis and the densities measured 1-1.5 cm. A pelvis computed tomography (CT) scan showed in-homogeneous uterine mass with unusual vascular supply raising concern for leiomyosarcoma. Open lung biopsy revealed benign-appearing smooth-muscle neoplasm suggestive of metastatic leiomyoma. The patient was then treated with total abdominal hysterectomy with bilateral salpingo-oopherectomy which had identical pathology to the lung. As there were innumerable pulmonary metastases where complete resection was impossible, surgical castration appeared to be effective in reducing tumor size. The patient was also started on an aromatase inhibitor that subsequently improved her clinical outcome. Management strategies, cytogenetics, and histological diagnosi...
Benign metastasizing leiomyoma of the lung
2013
Benign leiomyomas of the uterus are uncommonly found in association with benign smooth muscle tumors beyond the confines of the uterus. Benign metastasizing leiomyoma (BML) is a rare disease in which the lung is described to be the most afflicted extrauterine organ. We present a brief review of the literature, along with case reports for four patients who were followed up after resection of a pulmonary lesion or after pathological confirmation by biopsy. The clinical course of BML varies from chronic asymptomatic appearance to rapid progression, leading to respiratory failure and death. Our BML patients did not complain of pulmonary symptoms, such as cough, dyspnea, or chest tightness. Pathology revealed benign leiomyomas with no atypia and mitotic activity <5 per 10 high-power field. Immunohistochemical staining was positive for actin and desmin. A standard treatment for BML has not yet been established. Because of the hormone-sensitive characteristics of BML, treatments are based on hormonal manipulation along with either surgical or medical oophorectomy. Benign metastasizing leiomyoma can be observed in postmenopausal women. We observed four patients who did not receive adjuvant hormonal therapy because they were postmenopausal or perimenopausal. All patients are still healthy and show no evidence of recurrence or progression of the disease.
Pulmonary benign metastasizing leiomyoma from the uterine leiomyoma: a case report
Polish journal of radiology / Polish Medical Society of Radiology, 2015
Benign metastasizing leiomyoma (BML) is a rare condition described as multiple well-differentiated leiomyomas at sites distant from the uterus. Apart from lungs it has also been reported in lymph nodes, heart, brain, bone, skin, eye and spinal cord. We present a case of pulmonary benign metastasizing leiomyoma in a female patient admitted to our hospital with suspicion of left adnexal tumor. A 45-year-old woman was referred to our hospital with suspicion of left adnexal tumor. The control transvaginal ultrasound examination performed at admission to the Gynecological Department excluded adnexal neoplasm. However, a large amount of fluid within the Douglas pouch raised the oncological concern. The patient underwent myomectomy in 2005. In the same year she was diagnosed with multiple lung nodules and underwent pulmonary wedge resection with the diagnosis of pulmonary benign metastasizing leiomyoma being stated. The decision of reevaluation of the specimen, control CT and puncture of t...
Pulmonary benign metastasizing leiomyoma: a case report and review of the literature
World Journal of Surgical Oncology, 2012
Pulmonary benign metastasizing leiomyoma characterized by the growth of uterine leiomyoma in the lung is a very rare disease. We herein report the case of a 46-year-old asymptomatic woman who underwent a total abdominal hysterectomy for her multiple uterine leiomyomas 5 years ago, with the presence of multiple shadows in her chest roentgenogram during the regular check-up. Chest computerized tomography (CT) showed multiple solitary nodules in both lungs. Video-assisted thoracoscopic surgery with a wedge resection of the lesion was performed. Histopathologically, the pulmonary nodule was composed of benign smooth muscle cells and demonstrated low mitotic activity and absence of necrosis. Immunohistochemical staining for smooth muscle actin (SMA) and Desmin were extremely positive. CD10, CD117 and S-100 were negative in the tumor cells. Positive immunoreactivity for estrogen receptor (ER) and progesterone receptor (PR) were detected. The pathological diagnosis was pulmonary benign met...
Case Reports in Oncological Medicine, 2014
Benign metastasizing leiomyoma (BML) is a rare disease that usually occurs in women of reproductive age. They typically have history of uterine leiomyoma treated with hysterectomy. BML can metastasize to distant organs, with the lung being the most common organ. We report two patients who presented with benign metastasizing leiomyoma to the lung. Our first case was a fifty-two-year-old female who presented with multiple lung masses, with a past medical history of uterine leiomyoma who underwent hysterectomy 17 years ago. A CT-guided biopsy showed benign appearing spindle cells and pathology confirmed her diagnosis with additional positive estrogen/progesterone receptor stains. Our second case was a fifty-six-year-old female who presented with multiple cavitary pulmonary nodules. She subsequently underwent a video-assisted thoracoscopic surgery (VATS) with wedge resection of one of the nodules. Pathology confirmed the diagnosis based on morphology and immunohistochemical staining str...
BENIGN METASTASIZING LEIOMYOMA IN AN ELDERLY FEMALE, A CASE REPORT, AND REVIEW OF THE LITERATURE.
Benign Metastasizing Leiomyoma (BML) is a rare disease mostly seen among women in the fertile period with a previous history or coincidental finding of uterine leiomyoma. We report a case of pulmonary BML from the uterus in a 73-year-old woman who underwent myomectomy at the age of 55 years. Two years later she had multiple nodules identified in the lung fields by computed chest tomography. Pathological examination of lung biopsy confirmed the diagnosis of BML with a uterine origin, and she was treated with Tamoxifen. She represented with 2 months history of dyspnea, cough and chest pain. It is the fourth reported case in the Middle East, we discuss the course of the patient and discuss the clinical presentation and management of BML.