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      Benign Metastasizing Leiomyoma of the Lung with Spontaneous Pneumothorax

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          Abstract

          A 47-year-old woman was admitted with recurrent pneumothorax. Preoperative chest computed tomography (CT) showed multiple lung nodules and cysts bilaterally. She had undergone enucleatic myomectomy 12 years earlier. Video-associated thoracoscopic biopsy was performed. Histopathologically, there were bulla-like dilated cystic changes, the walls of which showed spindle cell proliferation, causing pneumothorax. Hormone therapy was started after benign metastasizing leiomyoma resection; pneumothorax has not recurred in 7 months. Multiple residual lung nodules have decreased or disappeared on CT.

          Most cited references6

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          Metastasizing fibroleiomyoma of the uterus: Report of a case and review of the literature.

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            Natural decrease of benign metastasizing leiomyoma.

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              Pulmonary metastases (with admixed epithelial elements) from smooth muscle neoplasms. Report of nine cases, including three males.

              This study pertains to an entity characterized by the presence of multiple intrapulmonary nodules, which consist of an admixture of bundles of well-differentiated smooth muscle cells and epithelial-lined spaces. These lesions have been frequently interpreted as a variant of hamartomas. However, in this review of the literature, and careful analysis of nine cases of this entity, we concluded that they should be considered metastases from smooth muscle tumors which incorporate some structures of mature lung parenchyma as they slowly expand. We affirm that the designation "fibroeliomyomatous hamartoma" should be discarded. Our cases occurred in six female and three male patients. In all but one female the primary source for lung metastases was uterus, while the male patients had primary lesions in the saphenous vein, diaphragm, and soft tissues. These lung lesions increase in size and number and are potentially fatal, though this may take many years. Even though the smooth muscle cells of the lung nodules appear bland on light microscopy, we were always able to demonstrate mitotic activity; electron microscopy indicated immaturity of the cells. For these reasons, we believe the tumors to represent metastatic leiomyosarcomas.
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                Author and article information

                Journal
                Thorac Cardiovasc Surg Rep
                Thorac Cardiovasc Surg Rep
                10.1055/s-00024355
                The Thoracic and Cardiovascular Surgeon Reports
                Georg Thieme Verlag KG (Stuttgart · New York )
                2194-7635
                2194-7643
                25 April 2013
                December 2013
                : 2
                : 1
                : 26-28
                Affiliations
                [1 ]Division of Thoracic Surgery, Matsue Red Cross Hospital, Matsue, Japan
                [2 ]Department of Thoracic Surgery, Kitano Hospital, Osaka, Japan
                Author notes
                Address for correspondence Ryo Okabe, MD Division of Thoracic Surgery, Matsue Red Cross Hospital 200 Horo-machi, Matsue, Shimane 690-8506Japan okabe2006@ 123456gmail.com
                Article
                130012
                10.1055/s-0033-1345266
                4176076
                25360407
                68978d82-e076-45d7-8203-f6b0485a1221
                © Thieme Medical Publishers
                History
                : 17 February 2013
                : 09 April 2013
                Categories
                Article

                benign metastasizing leiomyoma,pneumothorax
                benign metastasizing leiomyoma, pneumothorax

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