Case Of Benign Metastasizing Leiomyoma Research Articles

Ulipristal Acetate: Medical Management for Benign Metastasizing Leiomyoma?

Benign metastasizing leiomyoma (BML) is a rare disease characterized by smooth muscle tumors found outside of the uterus. Treatment options include surgery, embolization, and medical management. This case describes the use of ulipristal acetate in an attempt to medically manage an inoperable case of BML.

Clinicopathological features and gene phenotypes of benign metastasizing leiomyoma

Objective: To study the clinicopathological features, immunophenotypes and MED12 gene status in benign metastasizing leiomyoma (BML). Methods: Nine cases of BML diagnosed at the Affiliated Hospital of Qingdao University from 2012 to 2018 were collected, and the radiologic and histologic features were analyzed. The protein expression of leiomyosarcoma-related driver genes, including RB1, PTEN,ATRX,p16,p53, as well as ER,PR,CD34,FH, and Ki-67 were detected using immunohistochemistry, and the mutation status of MED12 gene exon 2 was detected by Sanger sequencing. Results: All the nine patients with BML were female, and the age range was 48 to 64 years (median 55 years). All patients had history of uterine fibroids. The morphologic features of BML were similar to a benign uterine leiomyoma and did not exhibit malignant characteristics. All cases were positive for ER and PR, and negative for CD34. In addition, RB1, PTEN, ATRX, and FH were positive in all cases (wild type), while p16 showed a focally positive pattern. P53 positive index was less than 5% (wild type), and Ki-67 positive index was less than 1%. Sanger sequencing was done in six BML samples; one sample harbored a nonsense mutation c. 142_144delinsTAA (p.Glu48Ter), and another exhibited a synonymy mutation (c.192C>T, p.Phe64=)and one missense mutation c.196C>T (p.Pro66Ser). Conclusions: The present study suggests that BML is a unique leiomyoma entity that is pathologically and genetically different from leiomyosarcomas and conventional uterine leiomyomas. Evaluating the genetic phenotype of BML, especially the expression of leiomyosarcoma-related driver genes protein and MED12 gene status, may be helpful in understanding the pathogenesis of BML and in its differentiation from leiomyosarcoma.

Epidural intracranial metastasis from benign leiomyoma: A case report with literature review

Uterine leiomyomas are benign tumors of smooth muscle oriin believed to result from a clonal proliferation of uterine smooth uscle tissue [1]. They are the most common gynecologic tumors iagnosed in women of reproductive age, and the most common ndication for hysterectomy. Rarely, a benign uterine leiomyoma an be found in sites of the body other than the uterus. It is called benign metastasizing leiomyoma (BML). BML is a slow growing etastatic tumor, usually associated with a current or prior hisory of a uterine leiomyoma. The lung is the most common site of ML, but extrauterine locations such as the pelvic cavity, retroperioneal space, and even the lymphatic and vascular channels have lso been reported. BML of the brain is extremely rare and very few ases have been reported [2]. It has similar radiologic features as meningioma, and consequentially has often been misdiagnosed. varian leiomyomas are rare as well, and constitute less than 1% f all benign ovarian tumors. The treatment of BML is surgical esection of the mass to exclude malignancy, and the outcome is enerally good. We present a case of BML of the brain and the ovary

Benign Metastasizing Leiomyoma

Pulmonary metastases from benign-appearing smooth muscle tumors of the uterus are rare, and are termed benign metastasizing leiomyoma (BML). Affected patients usually present with single or multiple lung nodules and are usually women who have undergone hysterectomy. Only a few cases of BML with lung cysts have been reported, with 2 patients presenting with spontaneous pneumothoraces. We report a case of BML in a 29-year-old woman with an abnormal preoperative chest radiograph who several years after hysterectomy developed spontaneous bilateral pneumothoraces.

Pulmonary and retroperitoneal benign metastasizing leiomyoma

Benign metastasizing leiomyoma (BML) is a rare disease, which usually occurs in women with a history of a prior hysterectomy or myomectomy for benign uterine leiomyoma, and has the potential to metastasize to distant sites, such as the lung, lymph nodes, muscular tissue, heart, or retroperitoneum. These lesions are slow-growing, asymptomatic, and usually found incidentally. The prognosis of BML is also excellent. However, there has been debate on the origin and the correct classification of BML, and there are no guidelines for the treatment of BML. We report here on a rare case of BML in both the retroperitoneal cavity and lung in a 48-year-old woman with a history of hysterectomy due to histologically benign uterine leiomyoma. The patient underwent retroperitoneal mass excision and bilateral salpingo-oophorectomy, and then wedge biopsy of two pulmonary nodules was performed additionally 9 days later. Until now, there has been no sign of recurrence and the patient remains asymptomatic. To our knowledge, pulmonary BML is rare and the co-existence of the retroperitoneal metastases after previous hysterectomy is even rarer.

Clinical benefit of endocrine therapy for benign metastasizing leiomyoma

Benign metastasizing leiomyoma (BML) is a rare disease that is caused by metastasis of a histologically benign leiomyoma that spreads to distant organs. Metastasis commonly follows surgical treatment of myomectomy or hysterectomy for benign uterine leiomyoma. Since the work of Steiner in 1939, several other studies have been published, but a unified view has not emerged regarding the biological nature, pathogenesis, and prognosis of this disease. In particular, a standard treatment has not been established. Here we report a case of BML of the lung and peritoneum in a premenopausal 45-year-old woman who underwent hysterectomy for uterine leiomyoma 10years earlier. A computed tomography (CT) scan showed multiple pulmonary nodules (maximum size 48mm) and a solitary intra-peritoneal nodule. The lung nodules were diagnosed as BML following a CT-guided needle biopsy. Histologically, the biopsied tumor was composed of spindle cells without significant atypia, and mitosis was not observed. Immunohistochemically, the tumor cells were strongly positive for smooth muscle actin, desmin, and estrogen receptor, suggesting a uterine leiomyomatous lineage. The patient was treated with a gonadotropin-releasing hormone agonist for 36months, during which time the nodules reduced in size slightly. No new lesions appeared, and the tumors were stable at 15months after the cessation of treatment. In conclusion, endocrine therapy can serve as one of the conservative treatments for premenopausal women with BML, rather than surgery.

Multiple benign metastasizing leiomyomas in the pelvic and para-aortic lymph nodes: A case report

Benign metastasizing leiomyoma (BML) is a rare entity, defined as a muscle tumor in association with one or more smooth muscle tumor of the uterus and without evidence of any extra uterine primary site. The lung is the most common site of involvement,2 and the etiology of BML remains unknown. We experienced a case of BML arising in pelvic and para-aortic lymph nodes and report with a brief review of literature.

Benign Metastasizing Leiomyoma of the Lung: Potential Role of Low-Grade Malignancy

We report here 2 cases of multiple metastatic lung tumors after hysterectomy for leiomyoma. One patient was diagnosed as having a benign metastasizing leiomyoma (BML), while the other patient simultaneously developed a left pelvic tumor and multiple lung tumors, both of which were finally diagnosed as low-grade endometrial stromal sarcomas (ESSs). The metastatic potential of BML is not completely understood, but previously reported cases of BML may include low-grade ESS, which may play a significant role in the metastasis of benign uterine tumors.

LUNG NODULES IN A PREMENOPAUSAL WOMAN

INTRODUCTION: Benign metastasizing leiomyoma (BML) is a rare clinical entity first described in 1939 by PE Steiner as “a tumor composed histologically, in both the primary growth and its metastasis, of benign appearing, fully differentiated smooth muscle cells and dense connective tissue”. The term benign metastasizing leimyoma was later coined by JP Horstman to distinguish the myometrial origin of the disease. Since its initial description, approximately 75 cases have been reported in the medical literature. Here, we report a case of BML in a pre-menopausal, 42 year-old woman who presented with an abnormal chest radiograph.

A case of benign metastasizing leiomyoma treated by surgical castration followed by an aromatase inhibitor, anastrozole

Benign metastasizing leiomyoma (BML) is a rare disease most often located in the lungs of women with a history of surgery for benign leiomyoma of the uterus. Optimum therapy for BML, has not been established. We report here an additional case of BML in the lung that was successfully treated with surgical castration followed by hormonal therapy with anastrozole, an aromatase inhibitor. A 46-year-old primigravid Japanese woman was admitted to our hospital for investigation of multiple pulmonary nodules found on a routine chest X-ray. At the age of 36, she had undergone myomectomy for uterine myomas. Upon gynecological examination, her uterus, was enlarged to the size of a child's head. Abdominal total hysterectomy, bilateral salpingo-oophorectomy, and thoracoscopic biopsy of pulmonary nodules were performed. Histologically, the lung nodules were diagnosed as BML. Subsequently oral anastrozole was started. The patient is alive and the size of the pulmonary nodules was stable, 15 months following the surgery. In addition to castration by bilateral oophorectomy or gonadotropin-releasing hormone agonist, the use of aromatase inhibitor is one of the treatment options for the further suppression of peripheral estrogen production in these patients.

A Case of Benign Metastasizing Leiomyoma with Multiple Metastasis to the Soft Tissue, Skeletal Muscle, Lung and Breast

Benign metastasizing leiomyoma (BML) is composed of well-differentiated smooth muscle cells and dense connective tissue. BML affects middle-aged women who have had previous hysterectomies due to a histologically benign-appearing uterine leiomyoma. We report here on a case of BML from the uterine leiomyoma in a 39-year-old woman that involved the soft tissues, skeletal muscles, lungs and breasts. She underwent a hysterectomy for the uterine leiomyoma, double oophorectomy for hormonal ablation and lung wedge resection to confirm the diagnosis. The microscopic findings of the breast and lung tumor were similar to those of the benign uterine leiomyoma. Therefore, we consider that these lesions were breast and pulmonary metastases of the uterine leiomyoma. We report here on a rare case of benign metastasizing uterine leiomyoma that involved the soft tissue, skeletal muscles, lungs and breasts, and we include a review of the relevant literature.

Benign metastasizing leiomyoma responsive to megestrol: case report and review of the literature

Benign metastasizing leiomyoma (BML) is an unusual condition typically treated by surgical resection and hormonal therapy. A 37-year-old woman presented with dyspnea 6 years after uterine myomectomy. Computed tomographic scans showed pelvic and right-sided lung masses. Total abdominal hysterectomy and right salpingo-oophorectomy revealed only leiomyomas and benign ovarian cysts. Thoracotomy revealed multiple nodules consistent with leiomyomas. Estrogen and progesterone receptors on lung and uterine tissue were positive. A 21- x 18-mm residual area of neoplasm in the lung completely resolved 3 months after treatment with megestrol. The patient remains free of disease 3 years after lung resection. We present a rare case of BML in which the lung neoplasm responded to megestrol alone in the setting of intact ovarian function.

Benign metastasizing leiomyoma involving multiple sites: CT and MR findings

Benign metastasizing leiomyoma (BML), which are histologically identical to uterine leiomyoma, are rare tumors that are most commonly encountered in the lung although their involvement has been reported in other organs. To our knowledge, a case of BML simultaneously involving multiple organs has not been reported to date. We describe the computed tomography (CT) and magnetic resonance (MR) findings of BML, manifested as well-circumscribed, benign-looking solid masses with CT densities or MR signal intensities similar to ordinary leiomyomas, found in the lung, retroperitoneal space and pelvic cavity of a patient who underwent a hysterectomy due to a uterine leiomyoma.

Benign pulmonary metastasizing leiomyomatosis in pregnancy: a rare complication after cesarean section

Benign pulmonary metastasizing leiomyomatosis in pregnancy: a rare complication after cesarean section