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Abstract
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.
Highlights
Uterine leiomyomas, the most common gynecological neoplasms in women of reproductive age, have a prevalence of about 50% in women older than 30 years and result from clonal proliferation of uterine smooth muscle tissue [1,2]
benign metastasizing leiomyoma (BML) is a very rare disease that has been reported in association with uterine leiomyoma, and about 100 cases have been reported in the literature [5]
Benign metastasizing leiomyoma is a uterine leiomyoma with pulmonary metastasis occurring in young adulthood, especially during the premenopausal period
Summary
The most common gynecological neoplasms in women of reproductive age, have a prevalence of about 50% in women older than 30 years and result from clonal proliferation of uterine smooth muscle tissue [1,2]. X-ray showed small multiple nodules of variable size in both lower lung fields. She had not previously had pulmonary disease, such as pulmonary tuberculosis or pneumonia. Case 3 A 49-year-old primiparous perimenopausal woman was referred to the cardiothoracic and vascular surgery outpatient clinic of our hospital for further evaluation of incidental lung masses. A chest X-ray showed a 2.5-cm round nodule in the left lower lobe and a smaller welldefined ovoid nodule in the right upper lobe (Figure 3). The patient underwent a video-assisted thoracoscopic wedge resection of the left lower lobe and right upper lobe.The mass shows a irregular pale brown tissue fragment (Figure 4). The patient underwent total abdominal hysterectomy along with left adnexectomy She underwent lung needle biopsy of the multiple nodules. The patient was healthy without recurrence, for 2 years following the surgery
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