Benign abdominal and pulmonary metastasizing leiomyoma of the uterus.
BACKGROUND
Benign metastasizing leiomyoma (BML) is a rare disease in which the lung is described to be the most afflicted extrauterine organ.


METHODS
We report of a 42-year-old African woman with a BML in the abdomen and lung who had undergone a hysterectomy for uterine leiomyoma 10 years ago. She was admitted to our hospital for investigation of a huge tumor mass in the pelvis consisting of multiple nodules in the abdomen and left lung. Assuming an advanced intraperitoneal malignancy was present, a 'palliative' limited tumor debulking and due to a tumor compressing the sigmoid a Hartmann's procedure was performed.


RESULTS
The histopathologic examination showed a leiomyoma positive for estrogen receptor. Treatment was started with GnRH analoga. In the presence of a stable disease after 12 months, the patient underwent a re-laparotomy with a reanastomosis of the colon. Treatment was continued with GnRH analoga and the residual nodules have not increased in size during 36 months of follow-up.


CONCLUSIONS
The review of the literature supports the concept that the primary tumor of BML is located in the uterus and that leiomyomas in the uterus can metastasize leading via hematogenous spread to BML. However, the origin of the tumor remains controversial.
Egberts
Jan-Hendrik
JH
Department of General Surgery and Thoracic Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 7, Kiel 24105, Germany. janegberts@yahoo.com
Schafmayer
Clemens
C
Bauerschlag
Dirk O
DO
Jänig
Ute
U
Tepel
Juergen
J
D000005:Abdomen; D000328:Adult; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007889:Leiomyoma / Q000473:pathology*; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary*; D011859:Radiography; D014594:Uterine Neoplasms / Q000473:pathology* / Q000601:surgery / Q000628:therapy; D014599:Uterus / Q000473:pathology / Q000601:surgery