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Weekly Chest CasesArchive of Old Cases

Case No : 952 Date 2016-01-25

  • Courtesy of Geewon Lee / Pusan National University Hospital
  • Age/Sex 48 / F
  • Chief ComplaintAbnormality on routine checkup. Past medical history: pelvic surgery 9 years ago.
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Diagnosis With Brief Discussion

Diagnosis
Benign metastasizing leiomyoma
Radiologic Findings
Serial chest radiographs and CT scans over a period of 3 years show two slowly growing nodules, located in the RUL and LUL lingular division. The nodules are oval shaped with well-defined margins, and demonstrate no definite FDG uptake at PET/CT scans.
The patient had history of hysterectomy 9 years ago for uterine myoma. VATS lingular segmentectomy of the nodule was performed. Pathologic results were consistent with benign metastasizing leiomyoma (H-caldesmon, desmin, ER, PR: positive, HMB-45, CD34, S100: negative).
Brief Review
Benign metastasizing leiomyoma is a rare entity. Lungs are the most common site of metastasis. Women who have undergone hysterectomy for leiomyomas are most commonly affected.. Patients are usually asymptomatic with incidental observation of pulmonary lesions. Nodules can be seen 3 months to 20 years after hysterectomy. Although there have been reports of patient morbidity and mortality from benign metastasizing leiomyoma, the clinical course is usually indolent. Typical radiographic findings include well-circumscribed solitary or multiple pulmonary nodules ranging in size from a few millimeters to several centimeters in diameter scattered among normal lung. A miliary pattern is less common, but has been reported. Typically, nodules are not calcified and do not enhance after IV contrast and demonstrate no significant metabolic activity at PET/CT scans.
Please refer to
Case 215, Case 394, Case 413, Case 667, Case 847, Case 952,
References
1. di Scioscio V. et al. J Thorac Imaging. 2009;24:41-4 Benign metastasizing leiomyoma of the lung: PET findings.
2. Abramson S. et al. Benign Metastasizing Leiomyoma Clinical, Imaging, and Pathologic Correlation. Am J Roentgenol. 2001;176:1409-13

Keywords
Lung, Benign tumor,

No. of Applicants : 109

▶ Correct Answer : 93/109,  85.3%
  • - Armed Forces Seoul Hospital , Korea (South) Eui Jin Hwang
  • - Daejin Medical Center Bundang Jesaeng General Hospital , Korea (South) Donghwan Kim
  • - Kyoto University , Japan Akihiko Sakata
  • - Seoul National University Hospital , Korea (South) Hyoung-In Choi
  • - Nihon University Itabashi Hospital , Japan Yusuke Watanabe
  • - Juntendo University Hospital , Japan Akifumi Hagiwara
  • - Seirei Hamamatsu General Hospital , Japan Kenichi Mizuki
  • - ROKAF 10th Fighter Wing , Korea (South) Kun Woo Kang
  • - stanley medical college , India yazhini v
  • - SAISEIKAI KURIHASHI HOSPITAL , Japan YASUO OOKUBO
  • - Yokohama-asahi-chuo-general hospital , Japan Kyoko Nagai
  • - Eren Hastanesi Istanbul , Turkey Armagan Sarac
  • - University of Tsukuba Hospital , Japan Sodai Hoshiai
  • - Northern Yokohama Showa university , Japan Kota Watanabe
  • - Diskapi Yildirim Beyazit Hospital, Ankara , Turkey Meric Tuzun
  • - King Abdulaziz University Hospital , Saudi Arabia Amr Ajlan
  • - Fortis hospital , Mohali , India Shaleen Rana
  • - Himeji Redcross Hospital , Japan Soichiro Okamoto
  • - asan medical center , Korea (South) yunsun song
  • - SNUH , Korea (South) Juil Park
  • - Department of Radiology, Seoul National University Bundang Hospital , Korea (South) Sung Hyun Yoon
  • - HIA legouest , France matthieu pernin
  • - McGill University Health Center , Canada Alexandre Semionov
  • - NIMS, HYDERABAD , India bhaskar kakarla
  • - Niigata University , Japan Atsushi Uehara
  • - coimbatore medical college hospital , India keerthivasan sivanmani
  • - sunder lal jain hospital , India sanjeev vachher
  • - Kyungpook national university hospital , Korea (South) Nari Jung
  • - KITANO HOSPITAL , Japan SHIGETO KUBO
  • - GHICL , France manuel toledano
  • - Ajou University Hospital , Korea (South) Seulgi You
  • - Mallinckrodt Institute of Radiology , United States Naganathan Mani
  • - Government Medical College, Nagpur, India , India Krishna Prasad Bellam
  • - , Korea (South) Seon Young Park
  • - , Korea (South) BAEK YOOLIM
  • - Goa Medical College , India Paresh Desai
  • - Seoul National University Hospital , Korea (South) Jong Hyuk Lee
  • - Ajou university hospital , Korea (South) Pae Sun Suh
  • - MT agarwal hospital,Mulund, Mumbai , India ASHISH SARODE
  • - Seoul National University Hospital , Korea (South) Sunkyung Jeon
  • - Kyungpook national university , Korea (South) Chungeun Lim
  • - Union hospital,Wuhan , China Nan Diao
  • - The University of Tokyo Hospital , Japan Toshihiro Furuta
  • - Onomichi municipal hospital , Japan Hirofumi Mifune
  • - The University of Tokyo Hospital , Japan Takana Yamakawa
  • - Shiga University of Medical Science , Japan Akitoshi Inoue
  • - Ishikawa Matto Central Hospital , Japan Manabu Akimoto
  • - Okayama University Hospital , Japan Toshiyuki Komaki
  • - Centre Imagerie de Fribourg , Switzerland Benoit RIZK
  • - National Center hospital of Neurology and Psychiatry , Japan Kaoru Sumida
  • - The University of Tokyo Hospital , Japan Takeyuki Watadani
  • - Niigata City General Hospital , Japan Takao Kiguchi
  • - MUHC , Canada Hani AlSalam
  • - DELTA CARE HOSPITAL, THANJAVUR, INDIA , India SIVARAJA SUBRAMANIAM
  • - MBAL BURGAS , Bulgaria VLADISLAV RUSINOV
  • - Avrasya Hospital , Turkey Murat Ulusoy
  • - saveetha medical college hospital , India gayathri ganesh
  • - Policlinico Umberto I , Italy Paolo Baldassari
  • - Saitama-Sekishinkai Hosptal , Japan Mihoko Yamazaki
  • - Asan Medical Center , Korea (South) Hyung Jung Koo
  • - Asan Medical Center , Korea (South) Kye Jin Park
  • - Asan Medical Center, Ulsan University , Korea (South) Mi Young Kim
  • - ZIGONG TCM HOSPITAL OF CHINA , China Cao Cunyou
  • - privato , Italy genchi enzo
  • - istituti ospitalieri di cremona , Italy pietro sergio
  • - China Medical University , China zhang wei
  • - Kyungpook national universtiy hospital , Korea (South) Hong Jihoon
  • - Kizawa Memorial Hospital , Japan Shoji Okuda
  • - DAYA General Hospital,Thrissur,Kerala , India Raveendran TK
  • - CHU Poitiers , France CHAN paul
  • - the first affiliatited hospital of nanjing medical univercity , China Hai Xu
  • - SNUH , Korea (South) TAE HYUNG KIM
  • - Kizawa Memorial Hospital , Japan Yo Kaneko
  • - Asan , Korea (South) Sania ALBlushi
  • - Teikyo University Mizonokuchi Hospital , Japan Noriko Kobayashi
  • - IRSA LA ROCHELLE , France, Metropolitan BIGOT
  • - Kobe City Medical Center General Hospital , Japan Yasuhisa Kurata
  • - Les cedres St malo , France nicolas gautier
  • - Pneumologia Universitaria, Policlinico di Bari , Italy Mario Damiani
  • - Chonnam national university hospital , Korea (South) Noh Hoon
  • - Asan Medical Center , Korea (South) Soyeoun Lim
  • - Private sector , Greece Vasilios Tzilas
  • - CLINIQUE STE CLOTILDE , Reunion patrick MASCAREL
  • - University of Tsukuba, Dept of Radiologt , Japan Manabu Minami
  • - Neurociti Diagnostics , India Justin Moses
  • - The Jikei university , Japan Taku Gomi
  • - Kinki University Faculty of Medicine, , Japan Mitsuru Matsuki
  • - jaslok hospital & research centre mumbai , India JAINENDRA JAIN
  • - Onomichi Municipal Hospital , Japan Yoshihisa Masaoka
  • - Asan Medical Center , Korea (South) , Korea (South) Han Na Lee
  • - Medicheck health care , Korea (South) Chae Lim
  • - Shinmatsudo Central General Hospital , Japan Taku Tajima
  • - University of Tsukuba , Japan Toshitaka Ishiguro
▶ Correct Answer as Differential Diagnosis : 2/109,  1.8%
  • - Oita University, Faculty of Medicine , Japan Fumito Okada
  • - radiologist, aditya imaging centre , India vivek patel
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