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Wojtyś ME, Kacalska-Janssen O, Ptaszyński K, Lisowski P, Kunc M, Wójcik J, Grodzki T. Benign Metastasizing Leiomyoma of the Lung: Diagnostic Process and Treatment Based on Three Case Reports and a Review of the Literature. Biomedicines 2022; 10:biomedicines10102465. [PMID: 36289727 PMCID: PMC9599094 DOI: 10.3390/biomedicines10102465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/27/2022] [Accepted: 09/28/2022] [Indexed: 11/16/2022] Open
Abstract
Uterine leiomyomas may occasionally spread to the lungs forming nodular lesions detectable on chest X-ray. This condition known as benign metastasizing leiomyoma (BML) usually occurs in females with a history of hysterectomy or myomectomy. We present three cases of BML demonstrating the diagnostic process and treatment approaches. Two patients presented with the more common multiple-nodule variant while the other had a single mass, but all were symptom-free. The age of presented patients at diagnosis of BML ranged from 46-53. The first patient was diagnosed with BML at the age of 50, and 12 years prior to the diagnosis, underwent a supracervical hysterectomy. The second patient had a myomectomy at 36, and BML was diagnosed 17 years later at the age of 53. The third patient had a hysterectomy with bilateral salpingo-oophorectomy at the age of 46, with lung lesions present before the hysterectomy. Immunohistochemical studies of postoperative materials showed positive staining of spindle cells with antibodies against desmin and smooth muscle actin, as well as estrogen and progesterone receptors. The final histopathological diagnoses were pulmonary BML. All patients are stable and symptom-free: two at two years follow-up and one at six months follow-up.
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Affiliation(s)
- Małgorzata Edyta Wojtyś
- Department of Thoracic Surgery and Transplantation, Pomeranian Medical University in Szczecin, 70-891 Szczecin, Poland
- Correspondence: ; Tel.: +48-889944582
| | - Olga Kacalska-Janssen
- Department of Gynecological Endocrinology, Jagiellonian University Medical College, 31-501 Krakow, Poland
| | - Konrad Ptaszyński
- Department of Pathology, Faculty of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-561 Olsztyn, Poland
| | - Piotr Lisowski
- Students’ Scientific Circle of the Department of Thoracic Surgery and Transplantation, Pomeranian Medical University in Szczecin, 70-891 Szczecin, Poland
| | - Michał Kunc
- Department of Pathomorphology, Medical University of Gdansk, 80-214 Gdańsk, Poland
| | - Janusz Wójcik
- Department of Thoracic Surgery and Transplantation, Pomeranian Medical University in Szczecin, 70-891 Szczecin, Poland
| | - Tomasz Grodzki
- Department of Thoracic Surgery and Transplantation, Pomeranian Medical University in Szczecin, 70-891 Szczecin, Poland
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Uterine leiomyomas revisited with review of literature. Abdom Radiol (NY) 2021; 46:4908-4926. [PMID: 34057564 DOI: 10.1007/s00261-021-03126-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 05/07/2021] [Accepted: 05/19/2021] [Indexed: 01/10/2023]
Abstract
Uterine leiomyomas, more commonly known as fibroids, are the most common neoplasms of the uterus. These tumors have a profound effect on health care and cost worldwide. Depending on the race, uterine leiomyomas can be seen in 70-80% of all women. Although majority of the women with uterine leiomyomas remain asymptomatic, approximately 30% can present with symptoms. Diagnosing typical leiomyomas on imaging is straightforward. However, when large, located extrauterine and especially with degeneration, the diagnosis can be challenging on imaging. In this article, apart from reviewing the demographics and management of patients with leiomyomas, we describe in detail the imaging appearance of various atypical leiomyomas, uncommon locations outside the uterus and their important differential diagnosis that can have a profound effect on patient management.
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Zhang X, Wu L, Xu R, Zhu C, Ma G, Zhang C, Liu X, Zhao H, Miao Q. Identification of the molecular relationship between intravenous leiomyomatosis and uterine myoma using RNA sequencing. Sci Rep 2019; 9:1442. [PMID: 30723247 PMCID: PMC6363745 DOI: 10.1038/s41598-018-37452-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 11/21/2018] [Indexed: 11/21/2022] Open
Abstract
The purpose of this study was to explore the potential relationship between intravenous leiomyomatosis (IVL) and uterine myoma (UM) at the molecular level. RNA-sequencing was performed on IVL tumours, UM tumours, and adjacent normal uterine muscle. We compared the gene expression levels between IVL and normal uterine muscle, UM and normal uterine muscle, to identify differentially expressed genes (DEGs). Then we used Gene Ontology Enrichment Analysis to determine the functions of the DEGs and performed specimen cluster analysis. We obtained 98 DEGs between IVL and adjacent normal uterine muscle, and 61 DEGs between UM and adjacent normal uterine muscle. Functional enrichment of both IVL and UM DEGs showed that they are associated with hormone stimulus, extracellular matrix, and cell adhesion. Unsupervised clustering analysis showed that IVL and UM could not be separated completely. Among these dysregulated genes, we found that HOXA13 showed a distinct dysregulated status between IVL and UM. HOXA13 may therefore serves as a biomarker to distinguish IVL and UM. Our results showed that IVL and UM may have similar dysregulated gene networks. They may be closely related, and HOXA13 may serves as a biomarker to distinguish between IVL and UM.
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Affiliation(s)
- Xu Zhang
- Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China
| | - Liangcai Wu
- Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China
| | - Rongjian Xu
- Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China
| | - Chengpei Zhu
- Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China
| | - Guotao Ma
- Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China
| | - Chaoji Zhang
- Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China
| | - Xingrong Liu
- Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China
| | - Haitao Zhao
- Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China.
| | - Qi Miao
- Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China.
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Lee SR, Choi YI, Lee SJ, Shim SS, Lee JH, Kim YK, Sung SH. Multiple cavitating pulmonary nodules: rare manifestation of benign metastatic leiomyoma. J Thorac Dis 2017; 9:E1-E5. [PMID: 28203428 DOI: 10.21037/jtd.2016.11.112] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Benign metastasizing leiomyoma (BML) is a rare disease of pathologically benign, but the tumor metastasizes to other organs. The most common organ involved in BML is lung. Pulmonary involvement usually manifested as multiple nodules on chest X-ray, however we experienced an interesting case of a 52-year-old premenopausal woman who presented with multiple bilateral lung cavitations and nodules on a chest X-ray without any respiratory symptoms. Chest computed-tomography identified multiple cavitary lesions of 5-12 mm in diameter and well-defined nodules of 5-10 mm in diameter in both lung fields. Transthoracic needle biopsy was performed and the resected lesion consisted of benign spindle cells was positive for estrogen receptor (ER) and progesterone receptor (PR) and was diffuse positive for actin and desmin by immunohistochemical (IHC) staining, suggesting leiomyoma. The final diagnosis was benign pulmonary metastasizing leiomyoma (BPML) and the patient underwent subcutaneous injection of a gonadotrophin releasing hormone (GnRH) agonist for 12 months, follow-up low-dose chest computed tomography (CT) scan at 15 months revealed decreased cavitations and nodular lesions. We should take into consideration the possibility of BPML when we encounter multiple cystic or cavitary lesions on chest X-ray, although the common form of BPML is nodulary lesions on imaging studies.
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Affiliation(s)
- Sa Ra Lee
- Departments of Obstetrics and Gynecology, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Youn-I Choi
- Department of Internal Mediciney, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Seok Jeong Lee
- Department of Internal Mediciney, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Sung Shine Shim
- Department of Radiology, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Jin Hwa Lee
- Department of Internal Mediciney, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Yoo Kyung Kim
- Department of Radiology, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Soon Hee Sung
- Department of Pathology, Ewha Womans University School of Medicine, Seoul, Republic of Korea
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Pan J, Wang S, Zhang Y, Fan Z. Mammary myofibroblastoma in the right lateral abdominal wall. World J Surg Oncol 2016; 14:55. [PMID: 26911514 PMCID: PMC4766690 DOI: 10.1186/s12957-016-0796-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 02/16/2016] [Indexed: 12/11/2022] Open
Abstract
Background A mammary-type myofibroblastoma is a rare soft tumor; extramammary myofibroblastomas are especially rare. Case presentation A 51-year-old woman presented to our department for evaluation of a mass on the right lower abdominal wall. The mass was then excised completely. Gross examination showed a huge, well-circumscribed soft tissue mass. The pathologic diagnosis was an extramammary myofibroblastoma. There was no recurrence after excision at the 6-month follow-up visit. Conclusions A mammary-type myofibroblastoma is a benign soft tissue neoplasm. No malignant behavior and/or recurrence of mammary-type myofibroblastomas after surgical resection have been described as a function of size and location. The present case aimed to provide a possible differential diagnosis for such abdominal masses.
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Affiliation(s)
- Jiyong Pan
- Department of General Surgery, the Third People's Hospital of Dalian (Dalian Third People's Hospital Affiliated to Dalian Medical University), Dalian, 116033, China
| | - Shuang Wang
- VIP Department, Affiliated Zhongshan Hospital of Dalian University, Dalian, 116001, China
| | - Yingyi Zhang
- Department of General Surgery, the Third People's Hospital of Dalian (Dalian Third People's Hospital Affiliated to Dalian Medical University), Dalian, 116033, China
| | - Zhe Fan
- Department of General Surgery, the Third People's Hospital of Dalian (Dalian Third People's Hospital Affiliated to Dalian Medical University), Dalian, 116033, China.
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