Cancer Res Treat.  2011 Jun;43(2):131-133.

Benign Metastasizing Leiomyoma with Multiple Lymph Node Metastasis: A Case Report

• Yoon G
• Kim TJ
• Sung CO
• Choi CH
• Lee JW
• Lee JH
• Bae DS
• Kim BG

Abstract

This is a case report about benign metastasizing leiomyoma with multiple lymph node metastasis. A 34-year-old woman received an abdominal myomectomy for a suspicious leiomyoma. On the pathology report, atypical leiomyoma was suspected. Due to the suspicion of multiple lymph node metastasis on pelvis computed tomography (CT) 1 year after the operation, she was transferred to the Samsung Medical Center on October, 2009 for further work up. According to original slide review, it was determined to be a benign leiomyoma with a mitotic count <5/10 high-power fields, little cytological atypia and no tumor cell necrosis. Additional immunostaining was done. Multiple lymph node metastasis and a small lung nodule were identified on positron emission tomogarphy-CT and chest CT. Extensive debulking surgery and diagnostic video-assisted thoracoscopic surgery (VATS) wedge resection were subsequently done. Metastatic lesions were reported to have a histology similar to that of the original mass. VATS right upper lobectomy with mediastinal lymph node dissection was performed because of the pathology result of VATS (adenocarcinoma). She started taking an aromatase inhibitor (Letrozole(R)) and there was no evidence of recurrence of disease on an imaging study and no post-operative complications until recently.

Keyword

Benign metastasizing leiomyoma; Leiomyoma; Lymphatic metastasis

MeSH Terms

Adult
Aromatase
Electrons
Female
Humans
Leiomyoma
Lung
Lymph Node Excision
Lymph Nodes
Lymphatic Metastasis
Necrosis
Neoplasm Metastasis
Pelvis
Recurrence
Thoracic Surgery, Video-Assisted
Thorax
Aromatase

Figure

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  Fig. 1 Original mass from a myomectomy specimen composed of benign looking spindle cells (H&E, ×200).

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  Fig. 2 Lymph node metastasis (para-aortic lymph node) (H&E, ×100).

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