Benign metastasizing benign pulmonary leiomyomatosis: a rare cause of pulmonary nodules. Case report.

Leiomiomatosis pulmonar benigna metastatizante: una causa rara de nódulos pulmonares. Reporte de caso

Benign metastasizing leiomyomatosis (BML) is a rare condition, first described by Forkel in 1910, and at least 150 cases have been reported in the literature so far (1). It is caused by metastasis and proliferation of smooth muscle tissue from a uterine myoma. At the imaging level, it manifests with multiple nodules located most frequently in the lung, lymph nodes, peritoneum, bone, heart and skin. In symptomatic cases, they are usually taken to surgical resection, bilateral oophorectomy and/or hormonal inhibition, some cases being refractory. We present the case of a 51-year-old woman, who came for consultation due to a clinical picture of 2 years of evolution characterized by progressive dyspnea, associated with dry cough and chest pain. A history of hysterectomy for dysfunctional uterine bleeding 14 years ago was documented, and pathology report concluded a diagnosis of uterine leiomyomatosis.  Chest CT scan revealed multiple non-calcified solid random pulmonary nodules. Samples obtained from the lung parenchyma were obtained by right thoracoscopy performing lateral segmental lobectomy of the middle lobe, with histopathological findings of mesenchymal proliferation, epithelial, and immunohistochemical markers compatible with metastatic leiomyomatosis.