[Two cases of metastatic lung tumor from leiomyosarcoma of the uterus].
Three pulmonary resections were performed for two cases of metastatic lung tumor from uterine leiomyosarcoma. Case 1 was diagnosed as myoma uteri. Preoperative chest X-ray examination showed an abnormal shadow in the left upper lobe. Postoperative diagnosis was leiomyosarcoma. During radiotherapy for the pelvic lesion, the lung tumor was growing very rapidly and micrometastases were detected bilaterally without distant metastasis. Bilateral pulmonary resections were performed. Three months and 15 days later, second left pulmonary and thoracic wall resections were performed because of lung and pleural recurrence. Seven months after the first pulmonary operation, she died of systemic metastases. Case 2 was admitted to the hospital because of genital bleeding and diagnosed leiomyosarcoma of the uterus. The patient had a metastatic lung tumor in the left lower lobe preoperatively. Eighteen days after hysterectomy, left lower lobectomy was performed because progressive hemoptysis occurred for rapidly enlarged metastatic lesion. She died of intrapelvic bleeding three months after the operation without respiratory symptom. The prognosis of synchronously found out lung metastasis from uterine leiomyosarcoma is very poor. Neither chemotherapy nor radiotherapy is effective. Although it's difficult and controversial to decide the surgical indication, we need to operate on as soon as possible when there is no other distant metastasis. Even if the timing of operation is late, we can find the surgical significance of pulmonary resection for reduction of respiratory symptoms and probability of longer survival.
Tatsuta
M
M
Department of Surgery, Sakai Municipal Hospital, Japan.
Yamada
T
T
Ikeda
M
M
Okuyama
M
M
Kimura
F
F
Ishikawa
K
K
Kawasaki
T
T
Satomi
T
T
Boku
K
K
Hanai
J
J
D005260:Female; D006801:Humans; D007890:Leiomyosarcoma / Q000556:secondary* / Q000601:surgery; D008175:Lung Neoplasms / Q000556:secondary* / Q000601:surgery; D008875:Middle Aged; D011013:Pneumonectomy; D014594:Uterine Neoplasms / Q000473:pathology*