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Benign metastasizing leiomyoma responsive to megestrol: case report and review of the literature
  1. G. K. WENTLING*,
  2. B. U. SEVIN,
  3. X. J. GEIGER and
  4. M. D. BRIDGES§
  1. *Section of General Surgery, Mayo Clinic, Jacksonville, Florida
  2. Departments of Obstetrics and Gynecology, Mayo Clinic, Jacksonville, Florida
  3. Departments of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, Florida
  4. §Department of Radiology, Mayo Clinic, Jacksonville, Florida
  1. Address correspondence and reprint requests to: Bernd-Uwe Sevin, MD, PhD, Department of Obstetrics and Gynecology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA. Email: sevin.bernd-uwe{at}mayo.edu

Abstract

Benign metastasizing leiomyoma (BML) is an unusual condition typically treated by surgical resection and hormonal therapy. A 37-year-old woman presented with dyspnea 6 years after uterine myomectomy. Computed tomographic scans showed pelvic and right-sided lung masses. Total abdominal hysterectomy and right salpingo-oophorectomy revealed only leiomyomas and benign ovarian cysts. Thoracotomy revealed multiple nodules consistent with leiomyomas. Estrogen and progesterone receptors on lung and uterine tissue were positive. A 21- × 18-mm residual area of neoplasm in the lung completely resolved 3 months after treatment with megestrol. The patient remains free of disease 3 years after lung resection. We present a rare case of BML in which the lung neoplasm responded to megestrol alone in the setting of intact ovarian function.

  • benign metastasizing leiomyoma
  • lung neoplasm
  • megestrol
  • progesterone

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