Published in Cancer Detection and Prevention 2000; 24(Supplement 1).

A case of so-called metastasizing leiomyomas

C Kratz MD 1, S Olbricht MD 1, JA Schmitt MD 2, W Weise MD PhD 1

1 Dept Obstetrics and Gynecology, 2 Dept Pathology, University of Magdeburg, Sachsen-Anhalt, Germany,

AIM: We are presenting a case of so-called metastasizing uterine leiomyomas to illustrate the difficulty in diagnosis and the necessity for an individual management in treatment. METHODS: The clinical course including histology and imaging of a premenopausal woman developing multiple leiomyomatous tumors of the lungs and extremities following hysterectomy for uterine leiomyomas is demonstrated. Controversial opinions regarding histological nature, differential diagnosis and various treatment methods are discussed in relation to the presented case. RESULTS: So-called metastasizing leiomyoma is a very rare disease affecting premenopausal women. A histologically benign tumor of smooth muscle tissue produces metastases. The relationship to metastasizing sarcoma of the uterus is not entirely clear. As most leiomyomas express estrogen and/or progesterone receptors, hormonal treatment attempts are recommended. We are presenting an otherwise healthy premenopausal woman who underwent abdominal hysterectomy for uterine leiomyomas. 7 years later she developed histological benign leiomyomas of the lungs, 14 years after hysterectomy similar tumors of the extremities were diagnosed. Estrogen and progesterone receptors were immunohistologically detected. In our patient, the treatment using medroxyprogesterone acetate stopped tumor growing. CONCLUSION: Our presented case demonstrates the necessity for a reliable differential diagnosis and an individual therapy management including age, clinical course, imaging and histology. In our opinion gestagens benefit by the treatment of so-called metastasizing leiomyomas.

KEY WORDS: Leiomyomatosis, metastasizing leiomyomas, hormonal treatment.

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Paper presented at the International Symposium on Impact of Biotechnology on Cancer Diagnostic & Prognostic Indicators; Geneva, Switzerland; October 28 - 31, 2000; in the section on metastasis & prevention.