Benign Metastasizing Leiomyoma of the Lung: Potential Role of Low-Grade Malignancy

Abstract

We report here 2 cases of multiple metastatic lung tumors after hysterectomy for leiomyoma. One patient was diagnosed as having a benign metastasizing leiomyoma (BML), while the other patient simultaneously developed a left pelvic tumor and multiple lung tumors, both of which were finally diagnosed as low-grade endometrial stromal sarcomas (ESSs). The metastatic potential of BML is not completely understood, but previously reported cases of BML may include low-grade ESS, which may play a significant role in the metastasis of benign uterine tumors.

Benign metastasizing leiomyoma - metastasis - endometrial stromal sarcoma

References

• 1 Colby T V, Koss M N, Travis W D. Smooth muscle tumors. Tumors of the Lower Respiratory Tract. Third series. Washington DC; Armed Forces Institute of Pathology 1995: 353-360
• 2 Jautzke G, Müller-Ruchholtz E, Thalmann U. Immunohistological detection of estrogen and progesterone receptors in multiple and well differentiated leiomyomatous lung tumors in women with uterine leiomyomas (so-called benign metastasizing leiomyomas): a report on 5 cases.  Pathol Res Pract. 1996;  192 215-223
• 3 Oliva E, Clement P B, Young R H. Endometrial stromal tumors: an update on a group of tumors with a protean phenotype.  Adv Anat Pathol. 2000;  7 257-281
• 4 Satoh Y, Ishikawa Y, Miyoshi T, Mukai H, Okumura S, Nagakawa K. Pulmonary metastases from a low-grade endometrial stromal sarcoma confirmed by chromosome aberration and fluorescence in-situ hybridization approaches: a case of recurrence 13 years after hysterectomy.  Virchows Arch. 2003;  442 173-178
• 5 Abrams J, Talcott J, Corson J M. Pulmonary metastases in patients with low-grade endometrial stromal sarcoma: clinicopathologic findings with immunohistochemical characterization.  Am J Surg Pathol. 1989;  13 133-140
• 6 Itoh T, Mochizuki M, Kumazaki S, Ishihara T, Fukayama M. Cystic pulmonary metastases of endometrial stromal sarcoma of the uterus, mimicking lymphangiomyomatosis: a case report with immunohistochemistry of HMB45.  Pathol Int. 1997;  47 725-729
• 7 Inayama Y, Shoji A, Odagiri S, Hirahara F, Ito T, Kawano N. et al . Detection of pulmonary metastasis of low-grade endometrial stromal sarcoma 25 years after hysterectomy.  Pathol Res Pract. 2000;  196 129-134
• 8 Kim G Y, Sung C O, Han J, Park J O, Lee K S. Pulmonary metastases of uterine endometrial stromal sarcoma: diffuse micronodular and ground glass opacities: a case report.  J Korean Med Sci. 2004;  19 901-903
• 9 Matsuura Y, Yasunaga K, Kuroki H, Inagaki H, Kashimura M. Low-grade endometrial stromal sarcoma recurring with multiple bone and lung metastases: report of a case.  Gynecol Oncol. 2004;  92 995-998
• 10 Koga T, Ushijima K, Kage M, Ichiki M, Kitajima T, Narita Y. et al . Pulmonary metastasis of endometrial stromal sarcoma.  Kurume Med J. 2006;  53 95-97