대한흉부영상의학회 Korean Society of Thoracic Radiology

Discussion

Diagnosis With Brief Discussion

Diagnosis

Extra-pleural chest wall leiomyoma

Radiologic Findings

Fig 1-2. Chest PA radiographs show a newly noted ovoid mass opacity in the left lateral mid thorax that exhibits the incomplete border sign consistent with a pleural or chest wall lesion in the course of 5 months.
Fig 3-6. CT scans reveal a well-circumscribed lentiform mass with peripheral enhancement at the left lateral 7th intercostal space, forming an obtuse angle with the chest wall.
Note minimal bony remodeling of adjacent left 8th rib.
Fig 7-8 F-18 FDG PET/CT demonstrates high FDG uptake of the mass (maxSUV=4.2).

Brief Review

- Our case patient underwent complete resection of the tumor and was pathologically confirmed as leiomyoma.
- Leiomyomas are soft tissue tumors that originate from smooth muscles, usually occurring in the uterus, small intestine, or esophagus. Intrathoracic leiomyomas are extremely rare and are usually detected by chance during routine check-ups or diagnostic studies for other reasons.
- Primary extra-pleural leiomyoma is an extremely rare proliferation of smooth muscle origin arising in the extrapleural cavity of the lungs. It is a benign smooth muscle tumor with a low malignant potential but may increase in size with local invasion. Typical radiographic findings on CT demonstrate a well-defined solitary lesion, coursing from a few millimeters to several centimeters, with minimal invasion of adjacent structures. However, pathologic confirmation is needed for a definitive diagnosis.
- When located in atypical regions such as our case, these tumors are generally benign and completely resectable due to the minimally invasive nature of the tumor.

References

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