Pulmonary benign metastasizing leiomyoma: report of three cases
© Jeon et al.; licensee BioMed Central Ltd. 2013
Received: 21 August 2013
Accepted: 1 October 2013
Published: 20 October 2013
Benign metastasizing leiomyoma is very rare and usually occurs in women who undergo hysterectomy and myomectomy for uterine leiomyoma. This is a benign spindle-shaped smooth muscle cell tumor pathologically but metastasizes to the extrauterine organs. Lungs are the most common site of metastasis. We observed three cases of pulmonary benign metastasizing leiomyoma.
Uterine leiomyoma is the most common benign tumor in gynecology. It is a smooth muscle tumor with spindle cells. Very rarely, it spreads to the extrauterine organs as benign metastasizing leiomyoma. It is benign pathologically but malignant clinically. Lungs are the most common site of metastasis. There is controversy with the pathogenesis and treatment modality of this condition. We present three cases of benign metastasizing leiomyoma.
Benign metastasizing leiomyoma is a very rare disease. Steiner was the first to report this condition in 1939 . The definition of benign metastasizing leiomyoma is slow-growing extrauterine smooth muscle tumors with a history of surgery for uterine leiomyoma or presence of uterine leiomyoma. It is a benign condition. Lungs are the most common sites of metastasis. Most cases were reported in women of reproductive age. Disease-free interval was 3 months to 20 years after hysterectomy . Patients are usually asymptomatic and the lesions are identified on imaging study. Most cases showed multiple metastases and single metastasis is very rare . Clinical course is usually indolent  as leiomyoma is less than five mitoses per 10 HPFs without cellular atypia and necrosis. Well-defined, oval-shaped nodules ranging in size from a few millimeters to several centimeters are typical radiographic findings . Infrequently, cystic lesions , cavitary formation, and military patterns are also reported.
Surgical resection is the widely accepted option for the resectable tumors . These lesions are affected by sex hormones . In inoperable cases, bilateral oophorectomy and hormonal therapy may be alternative approach.
In conclusion, though benign metastasizing leiomyoma is rare, thoracic surgeons should consider this diagnosis in patients with a history of uterine leiomyoma. Resection should be considered for the resectable tumors.
Written informed consent was obtained from the patient for publication of this case report with images.
This manuscript has been edited by native English-speaking experts of BioMed Proofreading.
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