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Weekly Chest CasesArchive of Old Cases

Case No : 1233 Date 2021-06-07

  • Courtesy of So Hyeon Bak, Heon Han / Kangwon National University Hospital
  • Age/Sex 46 / F
  • Chief ComplaintIncidental radiographic abnormality, past history of hysterectomy (10 years ago)
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4

Diagnosis With Brief Discussion

Diagnosis
Benign metastasizing leiomyoma
Radiologic Findings
Fig 1. Chest PA shows two round nodules in the right lung.
Fig 2-4. Axial chest CT scans show well-defined and smoothly marginated nodules in RUL, RML, and LLL. The lesions slightly increased after 2 years.
Brief Review
Benign metastasizing leiomyoma is a rare entity that usually affects women after hysterectomy for leiomyomas. The lung is the most common site of involvement. Lesions are often incidentally discovered and are usually asymptomatic at presentation. The clinical course is indolent, and growth rates are dependent on hormonal stimulation.
The imaging findings are well-defined solitary or multiple nodules ranging in size from a few millimeters to several centimeters in diameter. Most nodules are not calcified and do not enhance after contrast medium administration. The nodules may occasionally show cavitation or calcification. Mediastinal and/or hilar lymphadenopathy is rare.
Benign metastasizing leiomyoma should be considered in any asymptomatic patient who presented with multiple pulmonary nodules and a history of uterine leiomyomas.
Please refer to
Case 1134, Case 1080, Case 952, Case 847, Case 667, Case 413, Case 394, Case 215,
References
1. Abramson S. et al. Benign metastasizing leiomyoma Clinical, imaging, and pathologic correlation. Am J Roentgenol. 2001; 176:1409-13.
2. Miller et al. Benign metastasizing leiomyomas to the lungs: an institutional case series and a review of the recent literature. Ann Thorac Surg 2016; 101:253-8.
Keywords

No. of Applicants : 111

▶ Correct Answer : 100/111,  90.1%
  • - Ishikawa Matto Central Hospital , Japan MANABU AKIMOTO
  • - Saitama-Sekishinkai Hosptal , Japan MIHOKO YAMAZAKI
  • - , Japan HIROAKI ARAKAWA
  • - Korea University Guro Hospital , Korea (South) LEE SEOKYOUNG
  • - ZIGONG TCM HOSPITAL OF CHINA , China CAO CUN YOU
  • - Kinki University Faculty of Medicine, , Japan MITSURU MATSUKI
  • - Showa University Fujigaoka Hospital , Japan KYOKO NAGAI
  • - Showa General Hospital , Japan MASAFUMI KAIUME
  • - Mayo Clinic , United States AKITOSHI INOUE
  • - Chungbuk National University Hospital , Korea (South) YEONGTAE PARK
  • - National cancer center hospital east , Japan SHIOTO ODA
  • - Other , Korea (South) HYEJIN YANG
  • - Dhq hospital faisalabad , Pakistan AMMAR AHMED
  • - , Korea (South) HYEYOUNG CHOI
  • - , United Kingdom SAMSON KADE
  • - Chonnam National University Hwasun Hospital , Korea (South) SEONGWOO CHO
  • - Chonbuk National University Hospital , Korea (South) MINGI SHIN
  • - McGill University Health Center , Canada ALEXANDRE SEMIONOV
  • - CHCB , France LE GUEN RAPHAEL
  • - Osaka Red Cross Hospital , Japan YUSUKE UTSUNOMIYA
  • - NIMS, HYDERABAD , India BHASKAR K
  • - National Center of Neurology and Psychiatry , Japan MOTO NAKAYA
  • - Inje University Haeundae Paik Hospital , Korea (South) HYUNGIN PARK
  • - , Italy PAOLO BALDASSARI
  • - Tiger Gate Hospital , Japan SHIN-ICHI CHO
  • - , Japan CHIAKI SATO
  • - Ichinomiya Nishi Hospital , Japan CHIHIRO KIGUCHI
  • - Asan Medical Center , Korea (South) EUNJI CHOI
  • - Chungbuk National University Hospital , Korea (South) JIYUN KANG
  • - Vita Hospital , Brazil DIOGO LAGO PINHEIRO
  • - Korea University Ansan Hospital , Korea (South) BYUK GYUNG CHOI
  • - Other , Korea (South) SEONGSU KANG
  • - DELTA CARE HOSPITAL, THANJAVUR, INDIA , India SIVARAJA SUBRAMANIAM
  • - Cabinet Capricorne, clinique sainte-clotilde , Reunion FABIEN HO
  • - Samsung Medical Center , Korea (South) JUHYUN KIM
  • - university of montreal , Canada Andrei Bogdan Gorgos I
  • - Chonbuk National University Hospital , Korea (South) JUNGHWAN KIM
  • - Qatif Central Hospital , Saudi Arabia HANI MAKKY ALSALAM
  • - Kangwon National University Hospital , Korea (South) HAN SOL KANG
  • - Shimada General Medical Center , Japan HAYATO NOZAWA
  • - National Center for Global Health and Medicine , Japan MASATOSHI HOTTA
  • - Other , Korea (South) HYEON IL CHOI
  • - , Korea (South) HYEWON CHOI
  • - The University of Tokyo Hospital , Japan TOSHIHIRO FURUTA
  • - Seoul National University Bundang Hospital , Korea (South) SUNG HYUN YOON
  • - Narayana Multispeciality Hospital Jaipur Rajasthan , India JAINENDRA JAIN
  • - Inje University Pusan Paik Hospital , Korea (South) JIYEON HAN
  • - Kyeongpook National University Hospital , Korea (South) HYEONJUN JANG
  • - Yeungnam University Medical Center , Korea (South) JONGSOO PARK
  • - , Korea (South) SOOYEON JEONG
  • - Gifu University Hospital , Japan Yo Kaneko
  • - VDC, HYDERABAD , India KARTHIK RAYASAM
  • - , Japan KANAE TAKAHASHI
  • - McGill , Canada MUTAZ ADNAN KHAIRO
  • - Intermed Hospital , Mongolia KHULAN KHURELSUKH
  • - Chonnam National University Hwasun Hospital , Korea (South) MYUNG WON SONG
  • - The University of Tokyo Hospital , Japan RYO KUROKAWA
  • - Samsung Medical Center , Korea (South) KYOWON GU
  • - , Korea (South) EUNJIN LEE
  • - Soonchunhyang University Hospital Bucheon , Korea (South) SEONGHWAN BYUN
  • - Mallinckrodt Institute of Radiology , United States NAGANATHAN MANI
  • - Osaka City General Hospital , Japan SHU MATSUSHITA
  • - Chungbuk National University Hospital , Korea (South) MIHYEON PARK
  • - Other , Korea (South) MINSU KIM
  • - Kyeongpook National University Hospital , Korea (South) MIRAN KIM
  • - University of Tsukuba, Dept of Radiology , Japan MANABU MINAMI
  • - Seoul National University Hospital , Korea (South) SE WOO KIM
  • - Seoul Veterans Hospital , Korea (South) SEONG WON JANG
  • - , Japan HIROAKI ARAKAWA
  • - Wuhan Union Hospital , China QIGUANG CHENG
  • - Chonnam National University Hwasun Hospital , Korea (South) JEONG YEOP LEE
  • - Columbia asia refferal hospital,Bengaluru , India PRAVIN KUMAR M
  • - Osmania Medical College, Hyderabad , India PURUSHOTHAMA RAO TUMMALA
  • - TB centre kasaragod. , India rikhy krishnan
  • - Asan Medical Center , Korea (South) BYUNGSOO IM
  • - Chonnam National University Hospital , Korea (South) KIM SANG GYUN
  • - Kyoto University Hospital , Japan SATOSHI IKEDA
  • - Fortis hospital , Mohali , India SHALEEN RANA
  • - University of Tsukuba Hospital , Japan SODAI HOSHIAI
  • - Apollo Hospitals , India SHRUTHI P
  • - Chonbuk National University Hospital , Korea (South) MINJEE KIM
  • - Toranomon Hospital , Japan KAORU SUMIDA
  • - Chonbuk National University Hospital , Korea (South) SEOYUN CHOI
  • - Ichinomiya Nishi Hospital , Japan Takao Kiguchi
  • - The University of Tokyo Hospital , Japan HIROSHI TAKUMIDA
  • - , Japan KAZUMA TERAUCHI
  • - Chonnam National University Hospital , Korea (South) SEUNG WAN KANG
  • - National Center for Global Health and Medicine , Japan TOMOKI IMOKAWA
  • - Chonbuk National University Hospital , Korea (South) YOUNG JU SONG
  • - Private sector , Greece VASILIOS TZILAS
  • - College of Medicine, CHA University , Korea (South) PARK JONG WON
  • - , Japan YUKI HAYASHI
  • - Diagnose.me (BV) / Royal Perth Hospital , Australia YURANGA WEERAKKODY
  • - Chonnam National University Hwasun Hospital , Korea (South) WONGI JEONG
  • - , Korea (South) WONJU HONG
  • - , Korea (South) JIHYUN KIM
  • - Kyoto university , Japan AKIHIKO SAKATA
  • - the first affiliatited hospital of nanjing medical univercity , China HAI XU
  • - Kyemyung University Dongsan Hospital , Korea (South) DONG HYEON KIM
  • - Jiangsu province hospital , China WANGJIAN ZHA
▶ Correct Answer as Differential Diagnosis : 1/111,  0.9%
  • - Other , Korea (South) KYU-CHONG LEE
▶ Semi-Correct Answer : 9/111,  8.1%
  • - Affilitated Hospital of Jining Medical college , China JIANG SHENG HUA
  • - , India DIWAKAR C
  • - HHS , Canada S LEE
  • - Other , Korea (South) JOO HEE KIM
  • - , United States HIROAKI TAKAHASHI
  • - Avrasya Hospital/ISTANBUL , Turkey MURAT ULUSOY
  • - CHU Lille , France PAUL LEBERT
  • - Hussein Dey Hospital , Algeria ADEL ALLAL
  • - Yeungnam University Medical Center , Korea (South) CHOI SOOYOUNG
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