Benign Metastasizing Leiomyoma

Abstract

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.

Cancer Genes Mutations in Benign Metastasizing Leiomyoma: A Case Report

“…Prognosis depends on rate of progression and responsiveness to treatment. Time interval between hysterectomy and BML presentation is typically 15 years [1][2][3][4][5][6][7]. In an evaluation of 57 patients reported in the literature, survival from time of BML diagnosis is by average 11.6 years [14].…”

“…Most presentations involve the lungs, but may also involve lymph nodes, heart, brain, skin, and eye [2][3][4]. For the majority of the time, patients presented without symptoms and have incidental findings of small pulmonary nodules on chest X-ray or computed tomography scan (CT scan), but also sometimes presented with coughs, shortness of breath, hemoptysis, pleural effusions, or pneumothorax [5][6][7]. The pathogenesis of BML has not been clearly defined.…”

An Unusual Cause of Pulmonary Nodules in the Emergency Department

“…The nodules are usually found after hysterectomy or after myomectomy at durations of 3 months to 20 years [ 3 ]. BML may also be found concurrently at diagnosis of uterine leiomyomas in patients who present with leiomyoma symptoms (i.e., vaginal bleeding and abdominal or pelvic pain) [ 5 ] or in the perioperative period [ 6 ]. Uncommonly, BML involving the lung presents with a nonproductive cough or mild chest/back pain.…”

“…Respiratory failure secondary to a large leiomyoma of the left lower lung that extended and obstructed the right mainstem bronchus has been reported [ 7 ]. Rarely, BML presents with hemoptysis [ 8 ], pneumothorax associated with lung cysts [ 5 ], hemothorax [ 9 ], or empyema [ 10 ]. Further, BML may have extrapulmonary manifestations including a systolic murmur by right ventricular metastasis [ 11 ]; abdominal pain by pelvic metastasis [ 12 ]; jaundice by metastasis to the pancreatic head [ 13 ]; arm and shoulder pain by metastatic compression of the infraclavicular brachial plexus [ 14 ]; severe low back pain and saddle anesthesia by metastasis to the S2 vertebral body with expansion into the spinal canal [ 15 ]; and abducens and hypoglossal nerve palsy by metastasis to the posterior cranial fossa [ 15 ].…”

“…BML lung nodules typically do not calcify or enhance after intravenous contrast administration [ 5 ]. They may cavitate [ 16 ] and raise additional diagnostic considerations on imaging.…”