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Benign Metastasizing Leiomyoma of the Lung with Spontaneous Pneumothorax

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      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.

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      Most cited references 7

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

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        Catamenial and noncatamenial, endometriosis-related or nonendometriosis-related pneumothorax referred for surgery.

        Catamenial and endometriosis-related pneumothorax are considered relatively rare entities. Their clinical characteristics and outcome are incompletely known.
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          Favorable response to antigonadal therapy for a benign metastasizing leiomyoma.

          Benign metastasizing leiomyoma and lymphangioleiomyomatosis (LAM) both are characterized by abnormal proliferation of smooth muscle-like cells in the lung. A 32-year-old African woman with a diagnosis of LAM underwent myomectomy for uterine leiomyomas. An alternative diagnosis of benign metastasizing leiomyoma was made on repeat lung biopsy. Treatment with leuprolide acetate decreased pulmonary infiltrates and improved lung function and exercise tolerance. Accurately diagnosing benign metastasizing leiomyoma has important implications for clinical outcome. Because its clinical presentation may be misleading, immunohistochemical techniques may assist in differentiating benign metastasizing leiomyoma from LAM. This is important because, in benign metastasizing leiomyoma, reduced tumor burden and improved pulmonary function may be achieved by suppressing gonadal steroids.

            Author and article information

            [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@
            Thorac Cardiovasc Surg Rep
            Thorac Cardiovasc Surg Rep
            The Thoracic and Cardiovascular Surgeon Reports
            Georg Thieme Verlag KG (Stuttgart · New York )
            25 April 2013
            December 2013
            : 2
            : 1
            : 26-28
            © Thieme Medical Publishers


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