Pulmonary benign metastasizing leiomyoma extending into the left upper pulmonary vein: a case report

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  • 肺良性転移性平滑筋腫から左上肺静脈に静脈内平滑筋腫症をきたした1例
  • ハイ リョウセイ テンイセイ ヘイカツ キンシュ カラ ヒダリウエ ハイ ジョウミャク ニ ジョウミャク ナイ ヘイカツ キンシュショウ オ キタシタ 1レイ

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Abstract

<p>Benign metastasizing leiomyoma (BML) is a rare disease, and although it is histopathologically benign, it can metastasize to the lungs and other organs. Here, we report a case of BML with multiple lung metastases after hysterectomy for uterine myoma that required multidisciplinary treatment because its size gradually increased and it extended into the pulmonary vein. A 71-year-old woman underwent hysterectomy for a leiomyoma at 63 years of age. Seven years later, multiple lung nodules were detected. Thus, diagnostic thoracoscopic partial left lung resection was performed, although positron emission tomography/computed tomography (CT) showed no fluorodeoxyglucose accumulation. A leiomyoma, suggesting BML, was histopathologically diagnosed. Four years later, as the residual lung tumor showed a tendency to gradually increase in size, radiofrequency ablation and intensity-modulated radiotherapy were performed. Three years later, CT revealed lung metastatic lesions extending into the left upper pulmonary veins. Although chemotherapy(Doc etaxel+Gemcitabine) was ineffective, considering the possibility of sudden changes, left upper lobectomy and pulmonary angioplasty were performed. No obvious malignant findings were found on histopathological examination. The patient is still being followed up for BML. Although BML is pathologically benign, it should be considered a low-grade leiomyosarcoma because it can become malignant and metastasize and have intravenous extensions. [Adv Obstet Gynecol, 74 (3) : 366-375, 2022 (R4.8)]</p>

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