肺良性转移性平滑肌瘤伴含液性囊性变的快速增大：一例报告
Rapid enlargement of pulmonary benign metastasizing leiomyoma with fluid-containing cystic change: a case report.
作者信息
Yanagihara Takahiro, Kobayashi Naohiro, Kawamura Tomoyuki, Kikuchi Shinji, Goto Yukinobu, Ichimura Hideo, Sato Yukio
机构信息
Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan.
出版信息
Surg Case Rep. 2022 May 5;8(1):84. doi: 10.1186/s40792-022-01444-3.
BACKGROUND
Pulmonary benign metastasizing leiomyoma (PBML) is a rare disease that can occur in women with a history of uterine leiomyoma. Despite its benign histological features, like a malignancy, leiomyomas can on rare occasion spread to the lung. Typically, PBML presents with asymptomatic multiple solid lung nodules with slow tumor progression, following hysterectomy. Here, we present an atypical case with rapid enlargement of PBML with fluid-containing cystic change.
CASE PRESENTATION
We experienced a case of a 49-year-old woman with bilateral lung nodules following hysterectomy. Two nodules in the right lung had cystic change with fluid in the tumors. Hormone therapy was initiated after surgical biopsy of the left lung confirmed a diagnosis of PBML. However, the cystic component of right upper lobe lesion enlarged rapidly over the following 7 months, and, considering the risk of malignant transformation or tumor rupture, right upper lobectomy was performed. Pathologically, the fluid-containing tumor was diagnosed as PBML.
CONCLUSION
Given the risk of rapid progression, we should carefully consider the surgical indications of fluid-containing PBML.
背景
肺良性转移性平滑肌瘤（PBML）是一种罕见疾病，可发生于有子宫平滑肌瘤病史的女性。尽管其组织学特征为良性，但与恶性肿瘤一样，平滑肌瘤在极少数情况下可扩散至肺部。典型的PBML表现为子宫切除术后出现无症状的多个实性肺结节，肿瘤进展缓慢。在此，我们报告一例非典型病例，PBML迅速增大并伴有含液性囊性改变。
病例介绍
我们遇到一例49岁女性，子宫切除术后出现双侧肺结节。右肺的两个结节有囊性改变，肿瘤内有液体。左肺手术活检确诊为PBML后开始激素治疗。然而，右上叶病变的囊性成分在接下来的7个月内迅速增大，考虑到恶性转化或肿瘤破裂的风险，进行了右上叶切除术。病理检查显示，含液性肿瘤诊断为PBML。
结论
鉴于快速进展的风险，我们应仔细考虑含液性PBML的手术指征。
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