A rare case of benign abdominal wall and pelvic metastasizing leiomyomas following hysterectomy

Multiple benign metastasizing leiomyoma in the abdominal wall: a case report and literature review

Benign metastasizing leiomyoma (BML) is a rare disease that results from metastasis of uterine leiomyoma to distant sites with benign pathologic features. The lung is the most common metastatic site for BML. This report describes the case of a 49-year-old woman who presented with a mass in the abdominal wall with a surgical history of uterine myomectomy. Ultrasound and Magnetic resonance imaging (MRI) revealed multiple mass lesions. The histopathology of the mass specimen indicated BML. The imaging and clinical features of BML are discussed based on the characteristics of this case and related literature reports.

Novel hormone treatment of benign metastasizing leiomyoma: an analysis of five cases and literature review

OBJECTIVE

To evaluate novel hormonal therapies in patients with unresectable benign metastasizing leiomyoma (BML) disease.

DESIGN

Case series.

SETTING

National Institutes of Health (NIH).

PATIENT(S)

Five subjects with the diagnosis of BML based on imaging and/or histopathologic diagnosis.

INTERVENTION(S)

Four patients were treated with single or combination therapy of leuprolide acetate and/or an aromatase inhibitor. One patient was treated with an antiprogestin (CDB-2914).

MAIN OUTCOME MEASURE(S)

Response to therapy was measured by tumor burden on cross-sectional imaging employing RECIST (Response Evaluation Criteria in Solid Tumors) 1.1 guidelines.

RESULT(S)

Four patients treated with single or combination therapy of leuprolide acetate and/or an aromatase inhibitor demonstrated stable disease with reduction in tumor burden. The fifth patient treated with antiprogestin (CDB-2914) had degeneration of her tumor, progression of its size, and an improvement in symptoms.

CONCLUSION(S)

Hormone treatment with GnRH agonist and/or aromatase inhibition may be a therapeutic option to reduce tumor burden in unresectable BML disease or for those patients who wish to avoid surgical intervention. RECIST 1.1 guidelines, while traditionally used to evaluate tumor response to cancer therapeutics, may be useful in evaluating BML tumor burden response to hormone therapy.