Benign Metastasizing Leiomyoma. Female 58 years old Latin teacher in a French University Past history: 2003 hysterectomy for uterine leiomyomas -----------------------------------------------------

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Presentation transcript:

Benign Metastasizing Leiomyoma

Female 58 years old Latin teacher in a French University Past history: 2003 hysterectomy for uterine leiomyomas October 2010: abdominal pain CT scan NK

October NK

Percutaneous biopsy in a Cancer Center: Leiomyomatosis Hormonal receptors NK

Double J catheter Aromatase inhibitor Treatment stopped by the patient in march 2013 because of its intolerance and worsening functional signs NK

Sept 2013 (+ 3 years)

Surgery November 2013 Partial cystectomy: Enterocystoplasty Rectal resection (colo rectal anastomosis) Resection of the left external iliac vein Resection of part of vagina Resection of the nodule in the right iliac fossa NK

Pathology Main mass: 29 X 20 X16, cystic Spindle-shaped smooth muscle cells 0 mitosis /10 HPF Necrosis < 50% KI 67: 1% Vagina and bladder infiltrated No intra luminal tumor in the left external iliac vein Benign Metastasizing Leiomyoma 1 Nodule 8 X 5 cm: idem NK Desmin

Sept 2014 Asymptomatic No treatment