672 A case report of benign metastasizing leiomyoma

Introduction/Background* Benign metastasizing leiomyoma (BML) is a rare benign condition involving the extra-uterine spread of smooth muscle cells with histological, immunological, and molecular patterns similar to those uterine leiomyomas. Due uncommon nature disease, diagnosis treatment very challenging. There are no current standardized guidelines for BML but usually treated combination surgical resection radiotherapy, followed by hormonal monitored through radiography. Methodology This case 49 year old G0 an incidental finding in lungs. Routine pre-employment chest x-ray revealed pulmonary nodules. Computed tomography (CT) scan abdomen leiomyoma. Video-assisted thoracic surgery (VATS) wide nodules frozen section was done. Histopathology BML. Immunostains p53, Ki-67 p16 were negative, while immunostain estrogen progesterone receptor (ER/PR) positive. Serial radiography monitoring showed significant interval change patient remained asymptomatic. Few years later, presented enlarged abdomen. Transvaginal ultrasound pedunculated subserous myoma. The underwent exploratory laparotomy, extrafascial hysterectomy bilateral salpingooophorectomy. Result(s)* Currently, has been asymptomatic 6 changes size despite having multiple lesions both Conclusion* monoclonal tumor high metastatic potential. A hormone dependent, which growth depends primarily on progesterone. can metastasize distant organs commonly lung (PBML), hence, confused leiomyosarcoma. Uterine surgeries such as curettage, hysteromyomectomy cause it hematogenously venous circulation. Patients at presentation only incidentally discovered during routine physical examinations Thoracoscopic biopsy remains gold standard PBML. most helpful pathologic features that characterize PBML other BMLs their low cellularity mitotic index, absence nuclear atypia necrosis. Immunohistochemistry staining positive Desmin, Smooth Muscle Actin (SMA) ER/PR.