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Vol.43 No.6 contents | Japanese/English |
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- Case Report -
Benign Metastasizing Leiomyoma of the Lung: a Case of Long-term Follow-up After Diagnosis
Akira Nagashima1, Masayuki Kawasaki2, Hiroshi Wataya2, Takashi Yoshimatsu1, Toshihiro Osaki1Department of 1Chest Surgery, 2Respiratory Medicine, Kitakyushu Municipal Medical Center, Japan
Background. Benign metastasizing leiomyoma (BML) is a rare clinical entity that has been described in several previous reports, and most documents do not make mention of long-term consequences. Case. We present a case of BML in a 39-year-old woman followed up for a long time after diagnosis. She had undergone a total abdominal hysterectomy without oophorectomy for uterine myoma at age 37. Two years later, her chest roentgenogram showed multiple nodular shadows in the lung field. A thoracoscopic lung biopsy revealed leiomyomatous tumors that were pathologically similar to the uterine leiomyoma removed previously, and the tumors were eventually diagnosed as BML. In spite of medical castration using GnRH agonist (buserelin acetate) for six months after surgery, the residual lung tumors showed slight increased in size. After that, she received no further treatment for five years, and chest CT showed slight increase in size and number of the lung tumors. Then, six courses of GnRH agonist (leuprorelin acetate) were administered, and obtained decrease in the size of the tumors. Six years and 5 months after diagnosis and with no further therapy, the patient remains asymptomatic with very slowly growing lung tumors. Conclusion. Medical castration using GnRH agonist appears to be the treatment of choice in the pre-menopausal patient with BML.
key words: Pulmonary leiomyoma, Uterine leiomyoma, Benign metastasizing leiomyoma, Hormone therapy
Received: June 27, 2003
Accepted: July 16, 2003
JJLC 43 (6): 729-733, 2003
