Journal Information
Vol. 52. Issue 7.
Pages 391 (July 2016)
Clinical Image
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A Misleading Tumor. Benign Metastatic Leiomyoma
Un tumor desorientador. Leiomioma benigno metastásico
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Maria João Oliveiraa,
Corresponding author
, Agostinho Sanchesb, José Mirandac
a Servicio de Neumología, Centro Hospitalario de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, Portugal
b Servicio de Anatomía Patológica, Centro Hospitalario de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, Portugal
c Servicio de Cirugía Cardiotorácica, Centro Hospitalario de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, Portugal
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Leiomyoma is the most common form of uterine tumor. Although this tumor is benign, it may atypically present as metastasis, most commonly in the lung.1 Benign metastatic leiomyoma (BML) is usually detected in imaging studies of lung nodes in women with history of uterine fibroids. We present clinical images of a BML. Chest CT scan images show several well-defined, hypodense nodules of various sizes, scattered randomly in both lungs (Fig. 1: images A, B, and C). The diagnosis of BML was based on clinical history, histology and immunohistochemistry. Pathology images show proliferation of spindle cells without atypia, mitosis or necrosis, in a bundle arrangement which includes tubular and cystic structures of cubic or columnar epithelium, also without atypia (Fig. 1: images D, E). Immunohistochemistry for anti-desmin antibodies was positive (Fig. 1: image F). The majority of BML lesions are stable, but patients may develop complications, in which case, surgical resection should be considered, if feasible. For unresectable lesions, treatment options include tamoxifen, progesterone, aromatase inhibitors, luteinizing hormone-releasing hormone analogues, and estrogen receptor modulators.2

Fig. 1.

Images A, B, C – chest CT scan of BML; images D, E – pathology of lung biopsy with BML; image F – immunohistochemistry study for desmin in BML lung biopsy.

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References
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S. Chen, Y. Zhang, J. Zhang, H. Hu, Y. Cheng, J. Zhou, et al.
Pulmonary benign metastasizing leiomyoma from uterine leiomyoma.
World J Surg Oncol, 11 (2013), pp. 163
[2]
R. Yu, M. Ferri.
An unusual cause of pulmonary nodules in the emergency department.
Case Rep Emerg Med, 2015 (2015),

Please cite this article as: Oliveira MJ, Sanches A, Miranda J. Un tumor desorientador. Leiomioma benigno metastásico. Arch Bronconeumol. 2016;52:391.

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Archivos de Bronconeumología
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