Benign metastasizing leiomyoma

Cai, Anping; Li, L.; Tan, Haoyu; Mo, Yujing; Zhou, Yu

doi:10.1007/s00059-013-3904-1

Cited by 16 publications

(11 citation statements)

References 13 publications

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“…In review study, microscopic examination of haematoxylin and eosin slides has demonstrated the characteristic features of smooth muscle cell differentiation, which was also confirmed by immunohistochemistry smooth muscle actin positivity.Additional immunohistochemistry Ki67 showed a low tumour cell proliferation index, which favors a benign behavior [3,4,7,8,11–14,17,18,20–22,27,31–37, 41–55]. …”

Section: Discussionmentioning

confidence: 99%

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Benign metastasizing leiomyoma: A review of current literature in respect to the time and type of previous gynecological surgery

Książek²,

et al. 2017

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IntroductionBenign metastasizing leiomyoma (BML) is a rare disorder that affects women with a history of uterine leiomyoma, which is found to metastasise within extrauterine sites. The aetiology of BML remains unexplained. Because BML is rare, and most publications contain descriptions of single cases, no statistically determined time relations were found between the primary and secondary surgeries, which may have aetiological implications.ObjectivesTo determine age before BML surgery, age during diagnosis of BML, type of prior surgery, and location of metastasis based on the literature.MethodsA systematic review of four databases (Medline/PubMed, Embase, Web of Science, and Cochrane) covering articles published from 1 January 1965 to 10 April 2016. The inclusion criteria were full-text articles in English and articles containing case reports. Articles in languages other than English (39), articles containing incomplete data (14), i.e. no information regarding the time of surgery and/or the site of metastasis, articles bereft of case studies (25), and articles with access only to summaries, without access to the complete text (10) were excluded. Of 321 titles identified, only 126 articles met the aforementioned criteria.Results and conclusionsThe mean age during primary surgery and BML diagnosis was 38.5 years and 47.3 years, respectively. The most common surgery was total hysterectomy. The most frequent site of metastasis was the lungs; other organs were affected less frequently.The site of metastases and their number were not related to the longer time span between the patient’s initial surgery and occurrence of metastasis. The analysed data, such as the age during primary surgery, age during BML diagnosis, site and type of metastasis, do not provide us a clear answer. Thus, BML pathogenesis is most probably complex in nature and requires further multidirectional research.

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Section: Discussionmentioning

confidence: 99%

“…Hypothesisof genomic imbalance, such as the rearrangement of HMGA1 (6p21), shows the association of such changes with BML [20]. …”

Section: Discussionmentioning

confidence: 99%

Benign metastasizing leiomyoma: A review of current literature in respect to the time and type of previous gynecological surgery

Książek²,

et al. 2017

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“…Total hysterectomy is the most common type of uterine surgery to precede BML diagnosis. Moreover, lungs are the most common extrauterine site of spread at the time of diagnosis [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Molecular Profiling of Benign Metastasizing Leiomyoma of the Uterus Revealing Unique Novel Therapeutic Targets

Findakly

Wang

2020

Cureus

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Extra-uterine manifestations of benign uterine leiomyoma (fibroids) are rare. Benign metastasizing leiomyoma (BML) comprises an uncommon variant characterized by metastatic lung nodules. The pathologic characteristics for BML are well known in the literature; however, the underlying biology and molecular mechanisms remain poorly understood. We present a case of a 43-year-old woman who presented to the hospital complaining of dyspnea and lower extremity edema. Medical history includes a previous hysterectomy for leiomyomata two years prior. A reduced ejection fraction and right atrium globular filling defect are seen on transthoracic echo (TTE). CT scans of the chest, abdomen, and pelvis reported pelvic mass with an extensive inferior vena cava (IVC) thrombus extending into the right atrium, which was subsequently completely resected. Subsequent histopathology for the thrombus reported intravascular leiomyomatosis (IVL) and pelvic mass reported benign leiomyoma. Two years later, the symptoms recurred, and a chest CT revealed new pulmonary nodules. Subsequent pathology from a biopsy of these nodules was consistent with BML with ER+/PR+ on immunohistochemical staining. Genetic testing showed amplification of JUN, cyclin-dependent kinase 4 (CDK4), and MCL1, and loss of SUFU, AT-rich interaction domain 1A (AR1D1A), RB transcriptional corepressor 1 (RB1), and hepatocyte nuclear factor 1-alpha (HNF1A). The patient deemed to be a poor surgical candidate, and, therefore, she was started on hormonal treatment with leuprolide and letrozole. The disease remained stable upon follow-up at 48 months. Here, we report novel genomic profiling findings for the first time in a patient with a newly diagnosed BML. These findings may suggest molecular evidence that IVL may not be as benign as previously thought. Our study further highlights the value of genetic profiling in the understanding of this tumor's behavior and identification of new patient-specific therapeutic targets.

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“…BML usually occurs in women of reproductive age that present, most of the times, with a previous history of myomectomy or hysterectomy [2]. The leiomyomas can metastasize to several organs, the lungs being the most common target.…”

Section: Introductionmentioning

confidence: 99%

Multisystemic Benign Metastasizing Leiomyoma: An Unusual Condition with an Atypical Clinical Presentation

Matos

Santiago

Silva

2019

Case Reports in Radiology

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Benign metastasizing leiomyoma (BML) is a rarely found entity with few documented cases in the literature, usually occurring in women of reproductive age with a history of myomectomy or hysterectomy. The leiomyomas can metastasize to several organs, the lungs being the most commonly affected. We report a case of a 40-year-old female patient who presented at our institution with low back pain. She underwent a lumbar MR that revealed the presence of an expansive and compressive mass in the body of L4. This mass was biopsied, corresponding to a metastasizing leiomyoma with no malignant characteristics. Subsequently, a CT examination showed several soft tissue density round masses in both lungs, but the most striking feature was a 12 cm mass located in the left iliac crest. There was asymmetrical uterus enlargement, caused by the presence of several leiomyomas. Since the lesions were estrogen and progesterone positive, hormone suppression consisting of oophorectomy followed by anastrozole was the chosen treatment. No signs of progression were observed at the 6-month follow-up. This case is one of the very few that occurred in a woman with no previous uterine intervention, adding further evidence that surgery is not an essential condition for this entity to develop.

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Benign metastasizing leiomyoma

Cited by 16 publications

References 13 publications

Benign metastasizing leiomyoma: A review of current literature in respect to the time and type of previous gynecological surgery

Benign metastasizing leiomyoma: A review of current literature in respect to the time and type of previous gynecological surgery

Molecular Profiling of Benign Metastasizing Leiomyoma of the Uterus Revealing Unique Novel Therapeutic Targets

Multisystemic Benign Metastasizing Leiomyoma: An Unusual Condition with an Atypical Clinical Presentation

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