Aoki Kota, Yamamoto Takuro, Terauchi Ryu, Mori Taisuke, Shirai Toshiharu, Kitawaki Jo
Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi Hirokoji, Kamigyo-ku, Kyoto, Japan.
Department of Orthopedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi Hirokoji, Kamigyo-ku, Kyoto, Japan.
J Obstet Gynaecol Res. 2021 Feb;47(2):812-817. doi: 10.1111/jog.14545. Epub 2020 Nov 8.
Benign metastasizing leiomyoma (BML) is a rare disease that is characterized by well-differentiated smooth muscle tumors occurring extrauterine site in women with a history of uterine leiomyoma. The lung is the most common metastatic site for BML. A 48-year-old woman, who had histories of laparoscopic myomectomy and transabdominal total hysterectomy, visited an orthopedics complaining of a mass in her left thigh and difficulty in walking. Magnetic resonance imaging (MRI) and fluorine 18 fluorodeoxyglucose positron emission tomography/computed tomography revealed multiple mass lesions in her both thighs and left femur as well as both lungs. She was referred to our hospital for further examination. We diagnosed her tumors as BML according to histopathological analysis of tumor specimen. The left thigh tumor was resected and the treatment with gonadotropin releasing hormone agonist regressed the size of the residual tumors by approximately 30%. BML should be considered when multiple soft tissue tumors are found in women with a history of leiomyomas.
良性转移性平滑肌瘤(BML)是一种罕见疾病,其特征为在有子宫平滑肌瘤病史的女性子宫外部位出现分化良好的平滑肌肿瘤。肺是BML最常见的转移部位。一名48岁女性,有腹腔镜子宫肌瘤切除术和经腹全子宫切除术病史,因左大腿肿物及行走困难就诊于骨科。磁共振成像(MRI)和氟18氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描显示其双大腿、左股骨以及双肺均有多个肿物病灶。她被转诊至我院做进一步检查。根据肿瘤标本的组织病理学分析,我们将她的肿瘤诊断为BML。切除了左大腿肿瘤,使用促性腺激素释放激素激动剂治疗使残余肿瘤大小缩小了约30%。对于有平滑肌瘤病史的女性发现多个软组织肿瘤时,应考虑BML。