Introduction/Background Benign metastasizing leiomyomas (BMLs) represent the extrauterine spread of a benign uterine process. Pulmonary BMLs are the most common example of distant spread of uterine leiomyomas and are usually found incidentally in premenopausal women. We present the case of pulmonary benign metastasazing leiomyoma in a young patient 14 years after a myomectomy.

Methodology The patient S., 35 years old, in 2022 presented of chest discomfort during active physical activity. She had a history of myomectomy immediately after cesarean section in 2008. The clinical examination and laboratory findings were normal. The patient was referred for chest Computed Tomography (CT) and Magnetic Resonance Imaging of the abdomen, pelvis, and brain.

Results During CT of the chest, in both lungs multiple nodules from 0.2 to 0.8 cm were determined, which corresponded to disseminated process in the lungs, other examinations did not show any abnormality. Video-assisted thoracoscopic atypical resection of right lower lobe was performed. Morphological study revealed in the lung parenchyma two identical spindle-cell nodules without atypia. Immunohistochemical study shown immunophenotype of smooth muscle tumor: Desmin+, Caldesmon+, CD34-, CD117-, Estrogen+, Progesteron+, Ki67<1%. Pathology report: Metastatic leiomyoma with invagination of pulmonary epithelial structures.

Combining patient’s medical history with the examination results, she was diagnosed with pulmonary BML. Due to young age, low-symptomatic course and indolent disease progression, MTB adopted the tactics of careful observation.

During the year of close follow-up, the patient is alive with no signs of disease progression.

Conclusion Pulmonary BMLs are an extremely rare pathology. The treatment strategy for each case should be individualized. If the nodules are not resectable in young asymptomatic women wishing to preserve fertility close follow-up can be recommended.

Disclosures Authors do not have any disclosures.