Benign abdominal and pulmonary metastasizing leiomyoma of the uterus
Benign abdominal and pulmonary metastasizing leiomyoma of the uterus
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DOI：
10.1007/s00404-006-0165-8
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发表时间：
2006-08-01
影响因子：
2.6
通讯作者：
Tepel, Juergen
中科院分区：
文献类型：
--
作者：
Egberts, Jan-Hendrik;Schafmayer, Clemens;Tepel, Juergen
背景：良性转移性平滑肌瘤（BML）是一种罕见疾病，其中肺被描述为受影响最严重的宫外器官。方法：我们报道了一名 42 岁的非洲女性，腹部和肺部患有 BML，10 年前因子宫肌瘤接受了子宫切除术。她因骨盆内巨大肿瘤肿块入院，腹部和左肺有多个结节。假设存在晚期腹膜内恶性肿瘤，则进行“姑息性”有限的肿瘤减灭术，并且由于肿瘤压迫乙状结肠，因此进行了哈特曼手术。结果：组织病理学检查显示子宫肌瘤雌激素受体阳性。使用 GnRH 类似物开始治疗。 12 个月后，疾病稳定，患者接受了再次剖腹手术，并进行了结肠重新吻合术。继续使用 GnRH 类似物治疗，在 36 个月的随访期间，残留结节的尺寸没有增加。结论：文献综述支持BML原发肿瘤位于子宫且子宫内的平滑肌瘤可通过血行扩散导致BML转移的观点。然而，肿瘤的起源仍存在争议。
Background: Benign metastasizing leiomyoma (BML) is a rare disease in which the lung is described to be the most afflicted extrauterine organ. Methods: We report of a 42-year-old African woman with a BML in the abdomen and lung who had undergone a hysterectomy for uterine leiomyoma 10 years ago. She was admitted to our hospital for investigation of a huge tumor mass in the pelvis consisting of multiple nodules in the abdomen and left lung. Assuming an advanced intraperitoneal malignancy was present, a 'palliative' limited tumor debulking and due to a tumor compressing the sigmoid a Hartmann's procedure was performed. Results: The histopathologic examination showed a leiomyoma positive for estrogen receptor. Treatment was started with GnRH analoga. In the presence of a stable disease after 12 months, the patient underwent a re-laparotomy with a reanastomosis of the colon. Treatment was continued with GnRH analoga and the residual nodules have not increased in size during 36 months of follow-up. Conclusions: The review of the literature supports the concept that the primary tumor of BML is located in the uterus and that leiomyomas in the uterus can metastasize leading via hematogenous spread to BML. However, the origin of the tumor remains controversial.