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Current Medical Imaging

Editor-in-Chief

ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

Case Report

Multiple Leiomyomas in a Patient with Benign Metastasizing Leiomyoma: A Case Report

Author(s): Shuangjiao Liu*, Wenming Zhou and Weidong Fu

Volume 18, Issue 9, 2022

Published on: 25 May, 2022

Article ID: e250322202618 Pages: 4

DOI: 10.2174/1573405618666220325094428

Price: $65

Abstract

Introduction: Benign metastasizing leiomyoma (BML) is a rare disease and mostly affects females with a history of uterine leiomyoma, and particularly the presence of multiple leiomyomas in BML patients is extremely rare.

Case Presentation: This paper reported the clinical and imaging data of a BML patient with multiple leiomyomas involving bilateral pulmonary, mediastinum, pericardium, spine, peritoneum, and left thigh. Multiple BML lesions exhibited consistent imaging examinations, significantly improving the delayed phase enhancement. After multi-stage targeted therapy for multiple systemic metastases and the development of drug resistance, the patient was treated with hysterectomy and bilateral adnexectomy along with letrozole-based endocrine therapy. BML lesions, both pulmonary and mediastinum, became significantly smaller than before.

Conclusion: This paper aims to analyze the imaging and clinical features of multiple leiomyomas in this BML case, thus strengthening the understanding of the rare type of leiomyoma for effective preoperative diagnosis and clinical treatment. Furthermore, it is noteworthy that gynecologists should avoid the manifestation of BML when performing uterine fibroids surgery.

Keywords: Benign metastatic leiomyoma, imaging features, fibroids surgery, bilateral pulmonary, effective preoperative diagnosis, pulmonary.

Graphical Abstract

[1]
Fasih N, Prasad Shanbhogue AK, Macdonald DB, et al. Leiomyomas beyond the uterus: Unusual locations, rare manifestations. Radiographics 2008; 28(7): 1931-48.
[http://dx.doi.org/10.1148/rg.287085095] [PMID: 19001649]
[2]
Cohen DT, Oliva E, Hahn PF, Fuller AF Jr, Lee SI. Uterine smooth-muscle tumors with unusual growth patterns: Imaging with pathologic correlation. AJR Am J Roentgenol 2007; 188(1): 246-55.
[http://dx.doi.org/10.2214/AJR.05.1070] [PMID: 17179374]
[3]
Steiner PE. Metastasizing fibroleiomyoma of the uterus: Report of a case and review of the literature. Am J Pathol 1939; 15(1): 89-110.
[4]
Barnaś E, Książek M, Raś R, et al. Benign metastasizing leiomyoma: A review of current literature in respect to the time and type of previous gynecological surgery. PLoS One 2017; 12(4): e0175875.
[http://dx.doi.org/10.1371/journal.pone.0175875] [PMID: 28426767]
[5]
Ki EY, Hwang SJ, Lee KH, Park JS, Hur SY. Benign metastasizing leiomyoma of the lung. World J Surg Oncol 2013; 11(1): 279.
[http://dx.doi.org/10.1186/1477-7819-11-279] [PMID: 24134076]
[6]
Ma H, Cao J. Benign pulmonary metastasizing leiomyoma of the uterus: A case report. Oncol Lett 2015; 9(3): 1347-50.
[http://dx.doi.org/10.3892/ol.2015.2878] [PMID: 25663911]
[7]
Awonuga AO, Shavell VI, Imudia AN, Rotas M, Diamond MP, Puscheck EE. Pathogenesis of benign metastasizing leiomyoma: A review. Obstet Gynecol Surv 2010; 65(3): 189-95.
[http://dx.doi.org/10.1097/OGX.0b013e3181d60f93] [PMID: 20214834]
[8]
Ip PP, Tse KY, Tam KF. Uterine smooth muscle tumors other than the ordinary leiomyomas and leiomyosarcomas: A review of selected variants with emphasis on recent advances and unusual morphology that may cause concern for malignancy. Adv Anat Pathol 2010; 17(2): 91-112.
[http://dx.doi.org/10.1097/PAP.0b013e3181cfb901] [PMID: 20179432]
[9]
Park BK, Kim SH, Min HM. Benign metastasizing leiomyoma involving multiple sites: CT and MR findings. Eur J Radiol Extra 2003; 48(1): 19-22.
[http://dx.doi.org/10.1016/S1571-4675(03)00092-0]
[10]
Nuovo GJ, Schmittgen TD. Benign metastasizing leiomyoma of the lung: Clinicopathologic, immunohistochemical, and microRNA analyses. Am J Surg Pathol 2008; 17(3): 145-50.
[11]
Kayser K, Zink S, Schneider T, et al. Benign metastasizing leiomyoma of the uterus: Documentation of clinical, immunohistochemical and lectin-histochemical data of ten cases. Virchows Arch 2000; 437(3): 284-92.
[http://dx.doi.org/10.1007/s004280000207] [PMID: 11037349]
[12]
Jautzke G, Müller-Ruchholtz E, Thalmann U. Practice. Immunohistological detection of estrogen and progesterone receptors in multiple and well differentiated leiomyomatous lung tumors in women with uterine leiomyomas (so-called benign metastasizing leiomyomas). A report on 5 cases. Pathol Res Pract 1996; 192(3): 215-23.
[13]
Lipton JH, Fong TC, Burgess KR. Miliary pattern as presentation of leiomyomatosis of the lung. Chest 1987; 91(5): 781-2.
[http://dx.doi.org/10.1378/chest.91.5.781] [PMID: 3568785]
[14]
Shin MS, Fulmer JD, Ho KJ. Unusual computed tomographic manifestations of benign metastasizing leiomyomas as cavitary nodular le-sions or interstitial lung disease. Clin Imaging 1996; 20(1): 45-9.
[http://dx.doi.org/10.1016/0899-7071(94)00076-X] [PMID: 8846309]
[15]
Horstmann JP, Pietra GG, Harman JA, Cole NG, Grinspan S. Spontaneous regression of pulmonary leiomyomas during pregnancy. Cancer 1977; 39(1): 314-21.
[http://dx.doi.org/10.1002/1097-0142(197701)39:1<314:AID-CNCR2820390148>3.0.CO;2-N] [PMID: 318914]
[16]
Teixeira B, Mahfouz K, Escuissato DL, Costa A, Noronha LD. Solitary benign metastasizing leiomyoma: Imaging features and pathological findings. J Bras Pneumol 2014; 40(2): 193-5.
[17]
Zong D, He W, Li J, Peng H, Chen P, Ouyang R. Concurrent benign metastasizing leiomyoma in the lung and lumbar spine with elevated standardized uptake value level in positron-emission tomography computed tomography. Medicine 2018; 97(27): e11334.
[18]
Hur JW, Lee S, Lee JB, Cho TH, Park JY. What are MRI findings of spine benign metastasizing leiomyoma? Case report with literature re-view. Eur Spine J 2015; 24(S4)(Suppl. 4): S600-5.
[http://dx.doi.org/10.1007/s00586-015-3774-8] [PMID: 25632838]
[19]
di Scioscio V, Feraco P, Miglio L, et al. Benign metastasizing leiomyoma of the lung: PET findings. J Thorac Imaging 2009; 24(1): 41-4.
[http://dx.doi.org/10.1097/RTI.0b013e31818a0840] [PMID: 19242303]
[20]
Lin X, Fan W, Lang P, Hu Y, Zhang X, Sun X. Benign metastasizing leiomyoma identified using 18F-FDG PET/CT. Int J Gynaecol Obstet 2010; 110(2): 154-6.
[http://dx.doi.org/10.1016/j.ijgo.2010.03.017] [PMID: 20435308]
[21]
Li J, Dai S. Leiomyomatosis peritonealis disseminata: A clinical analysis of 13 cases and literature review. Int J Surg Pathol 2020; 28(2): 163-8.
[http://dx.doi.org/10.1177/1066896919880962] [PMID: 31615319]

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