Pulmonary benign metastasizing leiomyoma associated with intravenous leiomyomatosis of the uterus: clinical behavior and genomic changes supporting a transportation theory.
Benign metastasizing leiomyoma is a rare lesion characterized by benign-appearing smooth muscle tumor most frequently involving the lung and usually associated with a benign leiomyoma or intravenous leiomyomatosis of the uterus. The pathogenetic mechanism of the tumor has not been clarified, but the possibilities including hormone-sensitive in situ proliferations of smooth muscle bundles, mechanical displacement or intravascular spread of preexisting benign uterine tumor tissue, and metastasized very low-grade uterine leiomyosarcoma have been proposed. We described a case of pulmonary benign metastasizing leiomyoma associated with a uterine intravenous leiomyomatosis in a 46-year-old woman with a result of comparative genomic hybridization study. The 2 lesions showed significantly overlapping, if not identical, complex genomic changes in the comparative genomic hybridization, suggesting that the 2 lesions are closely related to each other. Unresected pulmonary nodules were left untreated for 13 months after the hysterectomy and wedge biopsy of 3 pulmonary nodules to show no further growth, suggesting clinical behavior of nonmalignant tumor in our case. Benign metastasizing leiomyomas may comprise a heterogeneous group of tumors in terms of their malignant potential and pathogenetic mechanism.
Lee
Hee Jin
HJ
Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Choi
Jene
J
Kim
Kyu-Rae
KR
D004273:DNA, Neoplasm; D005260:Female; D023281:Genomics; D006801:Humans; D007889:Leiomyoma / Q000235:genetics / Q000473:pathology*; D018231:Leiomyomatosis / Q000235:genetics / Q000473:pathology*; D008175:Lung Neoplasms / Q000235:genetics / Q000556:secondary*; D008875:Middle Aged; D009693:Nucleic Acid Hybridization; D014594:Uterine Neoplasms / Q000235:genetics / Q000473:pathology*
D004273:DNA, Neoplasm