benign metastasizing leiomyoma. female 58 years old latin teacher in a french university past...

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

2013 09637 NK

October 20102013 09637 NK

• Percutaneous biopsy in a Cancer Center: Leiomyomatosis

• Hormonal receptors +

2013 09637 NK

• Double J catheter• Aromatase inhibitor• Treatment stopped by the patient in march 2013

because of its intolerance and worsening functional signs

2013 09637 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 fossa2013 09637 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

2013 09637 NK Desmin

Sept 2014AsymptomaticNo treatment