When benign leiomyomas metastasize to the lungs - a case report

Abstract

Benign metastasizing leiomyoma is a rare disease occurring mainly in premenopausal women with a history of uterine leiomyoma, which is most commonly characterized by pulmonary metastases. The pathogenesis of this condition is poorly understood. Usually patients are asymptomatic or present unspecific symptoms. Pathological examination combined with immunohistochemistry is essential for the diagnosis. Treatment depends on the age, hormonal status, symptoms and extent of the lesions, with surgical resection being the most effective treatment. We report the case of a 72-year-old woman with a history of total hysterectomy due to myomas 30 years earlier that presented persistent dry cough. Her chest computed tomography revealed multiple small nodules in the pulmonary parenchyma. Given the small dimensions and difficult accessibility of the nodules, surgical biopsy was made for histopathological examination and immunohistochemical staining, which were compatible with metastasizing leiomyoma. Treatment with letrozole was initiated and well tolerated.