Benign Pulmonary Metastasizing Leiomyoma Uteri. Case Report and Review of Literature

Benign metastasizing leiomyoma (BML) is a rare condition in middle-aged women with a history of uterine leiomyomata. It ischaracterized by the proliferation of, usually multiple, smooth muscle nodules. Approximately 100 cases have been reportedin the literature, and the lungs were the most common site of metastases.We report a case of 52-year-old obese woman (BMI 31), hospital worker, smoker, admitted to the hospital with exertionaldyspnoea, night sweats, loss of weight, and productive cough.Hysterectomy for a uterine leiomyoma was performed 9 years earlier. In addition, a history of two episodes of superficialvein thrombosis 3 and 2 years before admission was noted. Chest X-ray and subsequently CT chest examinations revealedmultiple, non-calcified nodules within the middle and lower parts of both lungs. Specimens obtained by transbronchialbiopsy (TBLB) and from open lung biopsy displayed benign muscle cell proliferation compatible with BML. The levels of sexhormones were characteristic for the menopause; therefore, observation was advised. Additionally, Streptococcuspneumoniae was cultured from bronchial washing, and bronchitis was diagnosed. Antibiotics, bronchodilators, andmucolytics were administered, and dyspnoea and cough with expectoration were diminished. Two years later pulmonarylesions have been stable; however, she has put on weight. Subsequently the patient has developed deep vein thrombosiswith pulmonary embolism. Anticoagulant treatment was introduced, with some improvement.