Carcinoma, Renal Cell/surgery* ; Fumarate Hydratase ; Humans ; Kidney Neoplasms/surgery* ; Leiomyomatosis/pathology*

The authors report here on a case of a nearly asymptomatic 51-year-old Korean woman who was found to have diffuse, multiple nodules of the lungs on a routine chest radiograph. She had undergone hysterectomy 16 years previously for uterine myoma. An open lung biopsy revealed tumor that was composed of interlacing bundles of spindle cells with cigar shaped nucleus and eosinophilic myofibrils in the cytoplasm; consistent with multiple leiomyomas. The stains for SMA, desmin, MSA and Ki-67 were positive and the stain for c-kit was negative. The other stains for estrogen and progesterone receptor were positive. During the open lung biopsy procedure, all the nodules were excised. We report here on an interesting case of benign metastasizing leiomyoma (BML) in 51-year-old patient. To the best of our knowledge, this case showed the longest period of clinical progression in Korea. This is also one of a few cases in which curative excision was successfully performed.
Uterine Neoplasms/*pathology/surgery ; Ovariectomy ; Middle Aged ; Lung Neoplasms/diagnosis/*secondary ; Leiomyomatosis/*pathology/surgery ; Hysterectomy ; Humans ; Female ; Disease Progression

Adult ; Diagnosis, Differential ; Female ; Humans ; Hysterectomy ; Leiomyomatosis ; pathology ; surgery ; Sarcoma, Endometrial Stromal ; pathology ; Uterine Neoplasms ; pathology ; surgery ; Uterus ; blood supply ; Vascular Neoplasms ; pathology ; surgery

Actins ; metabolism ; Female ; Heart Atria ; pathology ; Heart Neoplasms ; secondary ; surgery ; Humans ; Iliac Vein ; pathology ; surgery ; Leiomyomatosis ; metabolism ; pathology ; surgery ; Middle Aged ; Uterine Neoplasms ; metabolism ; pathology ; surgery ; Vascular Neoplasms ; metabolism ; pathology ; surgery ; Veins ; pathology ; surgery ; Vena Cava, Inferior ; pathology

Adult ; Female ; Follow-Up Studies ; Heart Neoplasms ; secondary ; surgery ; Humans ; Leiomyoma ; pathology ; surgery ; Leiomyomatosis ; surgery ; Pelvic Neoplasms ; secretion ; surgery ; Pulmonary Artery ; pathology ; Reoperation ; Uterine Neoplasms ; pathology ; surgery ; Vascular Neoplasms ; secretion ; surgery ; Vena Cava, Inferior ; pathology

Adult ; Anticoagulants ; therapeutic use ; Carcinoma, Renal Cell ; complications ; pathology ; surgery ; Echocardiography ; Female ; Heart Atria ; diagnostic imaging ; pathology ; Humans ; Kidney Neoplasms ; complications ; pathology ; surgery ; Leiomyomatosis ; complications ; pathology ; surgery ; Thromboembolism ; diagnostic imaging ; drug therapy ; etiology ; Treatment Outcome ; Uterine Neoplasms ; complications ; pathology ; surgery

Leiomyomatosis peritonealis disseminata is usually asymptomatic or mimics widespread malignancy; acute presentation is rare. We describe a patient with right iliac fossa and lower abdominal pain. Two masses were detected via computed tomography, but at surgery, one of these implanted leiomyomas had undergone acute omental torsion. This case illustrates a rare complication of omental leiomyoma torsion clinically mimicking acute appendicitis.
Adult ; Diagnosis, Differential ; Female ; Humans ; Leiomyomatosis ; complications ; diagnosis ; Omentum ; pathology ; Peritoneal Neoplasms ; complications ; diagnosis ; Tomography Scanners, X-Ray Computed ; Torsion Abnormality ; etiology ; surgery

Adenoma ; metabolism ; pathology ; surgery ; ultrastructure ; Adnexa Uteri ; pathology ; surgery ; Adnexal Diseases ; metabolism ; pathology ; surgery ; Carcinoma, Endometrioid ; metabolism ; pathology ; Diagnosis, Differential ; Female ; Granulosa Cell Tumor ; metabolism ; pathology ; Humans ; Hysterectomy ; Keratins ; metabolism ; Leiomyomatosis ; pathology ; surgery ; Microscopy, Electron ; Middle Aged ; Neoplasms, Multiple Primary ; metabolism ; pathology ; surgery ; ultrastructure ; Sertoli-Leydig Cell Tumor ; metabolism ; pathology ; Uterine Neoplasms ; pathology ; surgery ; Vimentin ; metabolism ; WT1 Proteins ; metabolism

Objective To investigate the diagnosis and surgical treatment strategies of intravenous leiomyomatosis(IVL)extending through inferior vena cava into the right cardiac cavities. Methods Thirty patients of IVL extending through inferior vena cava into the right cardiac cavities were treated in Peking Union Medical College Hospital from November 2002 to January 2015.The following variables were studied: age,cardiopulmonary bypass time,deep hypothermic circulatory arrest time,origins of IVL,blood loss,duration of post-operative hospital stay,hospitalization expenses,edema of lower extremity,blood transfusion,postoperative complication,residual IVL,and re-grow or recurrence. Results Thirteen of 30 patients reported double lower limb edema. The cardiopulmonary bypass was applied in 27 cases,and the average duration of cardiopulmonary bypass was(106.9±53.7)min. Then,21 patients were treated with the deep hypothermic circulatory arrest,and the mean time was(28.2±11.6) min. The tumors originated from the genital veins in 9 cases,the iliac vein in 13 cases,and both veins in 8 cases. The average intra-operative blood loss volume was (2060.5±2012.3)ml,and 21 patients received blood transfusion. The average hospitalization time was(18.9±8.3)days and the average hospitalization expenses was (80 840.4±28 264.2)RMB yuan. While 14 patients had postoperative complications,there was no serious postoperative complication or death.All patients have shown a favorable outcome.Conclusions Tumor embolus extending through inferior vena cava into the right cardiac cavities should be suspected in patients with multiple hysteromyoma. Successful therapy for IVL with right cardiac cavities extension is dependent on reasonable surgical treatment strategies. Surgical removal of the ovaries is vital to avoid IVL re-grow or recurrence.
Cardiopulmonary Bypass ; Circulatory Arrest, Deep Hypothermia Induced ; Female ; Heart Neoplasms ; surgery ; Humans ; Leiomyomatosis ; surgery ; Length of Stay ; Neoplasm Recurrence, Local ; Ovary ; Postoperative Complications ; Vascular Neoplasms ; surgery ; Veins ; pathology ; Vena Cava, Inferior ; pathology

Antigens, CD34 ; metabolism ; Cysts ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Gastrointestinal Stromal Tumors ; metabolism ; pathology ; Humans ; Hysterectomy ; methods ; Leiomyomatosis ; metabolism ; pathology ; surgery ; Mesothelioma, Cystic ; metabolism ; pathology ; Middle Aged ; Pelvic Neoplasms ; metabolism ; pathology ; surgery ; Solitary Fibrous Tumors ; metabolism ; pathology ; surgery ; Uterine Neoplasms ; metabolism ; pathology ; surgery ; Vimentin ; metabolism