Leiomyomas beyond the uterus; benign metastasizing leiomyomatosis with paraaortic metastasizing endometriosis and intravenous leiomyomatosis: a case series and review of the literature

review OA: closed CC0 ⤵ 3 in-corpus citations
AI-generated summary by claude@2026-06+body, 2026-06-07

This case series presents benign metastasizing leiomyoma with concomitant endometriosis metastasis to paraaortic lymph nodes and a case of intravenous leiomyomatosis, including findings and surgical management.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text

This article reports a case series of rare leiomyoma patterns beyond the uterus, including benign metastasizing leiomyomatosis (BML) with a first-described concomitant metastasis of endometriosis to paraaortic lymph nodes, and a case of intravenous leiomyomatosis (IVL), alongside a review of related published cases. The authors describe surgical management and findings, using high-level clinical and pathologic correlation across the included reports as their primary method. The key finding is the documentation of the unusual co-occurrence of BML and paraaortic endometriosis metastasis, and the characterization of IVL as another diagnostic challenge in women with prior uterine smooth muscle tumor surgery. The limitation is that the evidence base is inherently small and descriptive, relying on case reports/series rather than a controlled comparison. Relevance to endometriosis: the paper is directly linked through its report of paraaortic “metastasizing endometriosis” occurring concomitantly with BML, though the broader focus is rare extrauterine leiomyoma entities.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Full text 9,803 characters · extracted from oa-doi-fallback · 2 sections · click to expand

Abstract

Uterine leiomyomas affect 20–30 % of women 35 years and older. Extrauterine leiomyomas are rare and present a greater diagnostic challenge. Those unusual growth patterns occur more often in women of reproductive age with a history of hysterectomy or surgery for uterine leiomyomas. They have been reported in the literature in case reports and small case series and include benign metastasizing leiomyoma (BML), disseminated peritoneal leiomyomatosis, intravenous leiomyomatosis (IVL), parasitic leiomyomas, and retroperitoneal growth. In this case series we present a case of BML with a first report of concomitant endometriosis metastasis to paraaortic lymphnodes, and a case of IVL. The findings and surgical management of those cases, as well as a review of the literature pertinent to those entities, are also presented.

References

Szklaruk J, Tamm EP, Choi H, Varavithya V (2003) MR imaging of common and uncommon large pelvic masses. Radiographics 23(2):403–424 Buttram VC Jr, Reiter RC (1981) Uterine leiomyomata: etiology, symptomatology, and management. Fertil Steril 36(4):433–445 Fasih N, Prasad Shanbhogue AK, Macdonald DB, Fraser-Hill MA, Papadatos D, Kielar AZ, Doherty GP, Walsh C, McInnes M, Atri M (2008) Leiomyomas beyond the uterus: unusual locations, rare manifestations. Radiographics 28(7):1931–1948 Steiner PE (1939) Metastasizing fibroleiomyoma of the uterus: report of a case and review of the literature. Am J Pathol 15:89–110 Rivera JA, Christopoulos S, Small D, Trifiro M (2004) Hormonal manipulation of benign metastasizing leiomyomas: report of two cases and review of the literature. J Clin Endocrinol Metab 11:3183–3188 Goyle KK, Moore DF Jr, Garrett C, Goyle V (2003) Benign metastasizing leiomyomatosis: case report and review. Am J Clin Oncol 11:473–476 Abramson S, Gilkeson RC, Goldstein JD, Woodard PK, Eisenberg R, Abramson N (2001) Benign metastasizing leiomyoma: clinical, imaging, and pathologic correlation. AJR Am J Roentgenol 176(6):1409–1413 Schneider T, Kugler C, Kayser K, Dienemann H (2001) Benign uterine leiomyoma with metastatic pulmonary nodales. Chirurg 72(3):308–311 Kwon YI, Kim TH, Sohn JW, Yoon HJ, Shin DH, Park SS (2006) Benign pulmonary metastasizing leiomvomatosis: case report and a review of the literature. Korean J Intern Med 21(3):173–177 Yoon G, Kim TJ, Sung CO, Choi CH, Lee JW, Lee JH, Bae DS, Kim BG (2011) Benign metastasizing leiomyoma with multiple lymph node metastasis: a case report. Cancer Res Treat 43:131–133 Kayser K, Zink S, Schneider T et al (2000) Benign metastasizing leiomyoma of the uterus: documentation of clinical, immunohistochemical and lectin-histochemical data of ten cases. Virchows Arch 437:284–292 Nayar AC, McAleer EP, Tunick PA, Applebaum RM, Colvin SB, Kronzon I (2002) Benign metastasizing leiomyomatosis diagnosed by echocardiography. Echocardiography 19:571–572 Kishore R, Richards AP, Evans N (2004) Benign metastatic leiomyoma. Clin Radiol Extra 54:29–31 Valdés Devesa V, Conley CR, Stone WM, Collins JM, Magrina JF (2013) Update on intravenous leiomyomatosis: report of five patients and literature review. Eur J Obstet Gynecol Reprod Biol 171(2):209–213 Beck MM, Biswas B, D’Souza A, Kumar R (2012) Benign metastasising leiomyoma after hysterectomy and bilateral salpingo-oophorectomy. Hong Kong Med J 4:153–155 Bender LC, Mitsumori LM, Lloyd KA, Stambaugh LE III (2011) AIRP best cases in radiologic–pathologic correlation: intravenous leiomyomatosis. Radiographics 31:1053–1058 Wilson M, Evans F, Mylona E, Murray C, Govind A (2011) Microscopic intravenous leiomyomatosis: an incidental finding at myomectomy. J Obstet Gynaecol 31:96–97 Mayerhofer K, Lozanov P, Bodner K, Bodner-Adler B, Kimberger O, Czerwenka K (2004) Ki-67 expression in patients with uterine leiomyomas, uterine smooth muscle tumors of uncertain malignant potential (STUMP) and uterine leiomyosarcomas (LMS). Acta Obstet Gynaecol 11:1085–1088 Gezginc K, Yazici F, Tavli L (2011) Uterine smooth muscle tumors of uncertain malignant potential: a case presentation. Int J Clin Oncol 11:592–595 D’Angelo E, Prat J (2010) Uterine sarcomas: a review. Gynecol Oncol 11:131–139 Giove S, Scappaticci E, Baldi S, Ricci C, Minetto E (1984) Benign metastasizing leiomyoma of the uterus. Case report. Minerva Med 75:1819–1821 Hoetzenecker K, Ankersmit HJ, Aigner C, Lichtenauer M, Kreuzer S, Hacker S, Hoetzenecker W, Lang G, Klepetko W (2009) Consequences of a wait-and-see strategy for benign metastasizing leiomyomatosis of the lung. Ann Thorac Surg 11:613–614 Funakoshi Y, Sawabata N, Takeda S, Hayakawa M, Okumura Y, Maeda H (2004) Pulmonary benign metastasizing leiomyoma from the uterus in a postmenopausal woman: report of a case. Surg Today 34:55–57 Cohen JD, Robins HI (1993) Response of “benign” metastasizing leiomyoma to progestin withdrawal. Case report. Eur J Gynaecol Oncol 11:44–45 Jacobson TZ, Rainey EJ, Turton CW (1995) Pulmonary benign metastasising leiomyoma: response to treatment with goserelin. Thorax 1225–1226:11 Abu-Rustum NR, Curtin JP, Burt M, Jones WBL (1997) Regression of uterine low-grade smooth-muscle tumors metastatic to the lung after oophorectomy. Obstet Gynecol 89:850–852 Jeon HW, Choi SH, Sung SW, Park JK (2013) Pulmonary benign metastasizing leiomyoma: report of three cases. World J Surg Oncol 11(1):281 Evans AJ, Wiltshaw E, Kochanowski SJ, MacFarlane A, Sears RT (1986) Metastasizing leiomyoma of the uterus and hormonal manipulations. Case report. Br J Obstet Gynecol 93:646–648 Liu IF, Yen YS, Cheng YM, Chou CY (2006) Mitotically active leiomyoma of the uterus in postmenopausal breast cancer patient receiving tamoxifen. Taiwan J Obstet Gynecol 45:167–169 Palomba S, Orio F, Russo T, Falbo A, Tolino A, Lombardi G (2005) Antiproliferative and proapoptotic effects of raloxifene on uterine leiomyomas in postmenopausal women. Fertil Steril 84:154–161 Wentling GK, Sevin BU, Geiger XJ, Bridges MD (2005) Benign metastasizing leiomyoma responsive to megestrol: case report and review of the literature. Int J Gynecol Cancer 15:1213 Hague WM, Abdulwahid NA, Jacobs HS, Craft I (1986) Use of LHRH analogue to obtain reversible castration in a patient with benign metastasizing leiomyoma. Br J Obstet Gynecol 93:455–460 Shozu M, Murakami K, Segawa T, Kasai T, Inoue M (2003) Successful treatment of symptomatic uterine leiomyoma in perimenopausal with nonsteroidal aromatase inhibitor. Fertil Steril 79:628–631 Parsanezhad ME, Azmoon M, Alborzi S, Rajaeefard A, Zarei A, Kazerooni R et al (2010) A randomized, controlled clinical trial comparing the effects of aromatase inhibitor (letrozole) and gonadotropin-releasing hormone agonist (triptorelin) on uterine leiomyoma volume and hormonal status. Fertil Steril 93:192–198 Lewis EI, Chason RJ, DeCherney AH, Armstrong A, Elkas J, Venkatesan AM (2013) Novel hormone treatment of benign metastasizing leiomyoma: an analysis of five cases and literature review. Fertil Steril 99(7):2017–2024 Chen S, Zhang Y, Zhang J, Hu H, Cheng Y, Zhou J, Shen L, Chen H (2013) Pulmonary benign metastasizing leiomyoma from uterine leiomyoma. World J Surg Oncol 11:163 Londero AP, Perego P, Mangioni C, Lellé RJ, Londero F, Marchesoni D (2008) Locally relapsed and metastatic uterine leiomyoma: a case report. J Med Case Reports 2:308 Du J, Zhao X, Guo D, Li H, Sun B (2011) Intravenous leiomyomatosis of the uterus. A clinicopathologic study of 18 cases, with emphasis on early diagnosis and appropriate treatment strategies. Hum Pathol 42:1240–1246 Kocica MJ, Vranes MR, Kostic D et al (2005) Intravenous leiomyomatosis with extension to the heart: rare or underestimated? J Thorac Cardiovasc Surg 130(6):1724–1726 Andrade LA, Torresan RZ, Sales JF Jr, Vicentini R, De Souza GA (1998) Intravenous leiomyomatosis of the uterus: a report of three cases. Pathol Oncol Res 4(1):44–47 Evans AT, Symmonds RE, Gaffey TA (1981) Recurrent pelvic intravenous leiomyomatosis. Obstet Gynecol 57(2):260–264 Grella L, Arnold TE, Kvilekval KH, Giron F (1994) Intravenous leiomyomatosis. J Vasc Surg 20(6):987–994 Kir G, Kir M, Guzbuz A, Karateke A, Aker F (2004) Estrogen and progesterone expression of vessel walls with intravascular leiomyomatosis: discussion of histogenesis. Eur J Gynaecol Oncol 25:362–366 Barksdale J, Abolhoda A, Saremi F (2011) Intravenous leiomyomatosis presenting as acute Budd–Chiari syndrome. J Vasc Surg 54:860–863 Lam PM, Lo KW, Yu MY et al (2004) Intravenous leiomyomatosis: two cases with different routes of tumor extension. J Vasc Surg 39:465–469 Surigami H, Kaura R, Ochi H (1990) Intravenous leiomyomatosis with cardiac extension: successful surgical management and histopatologic study. Obstet Gynecol 76:527–529 Barjot PJ, Refahi N, Berthet P, Delautre VD (1998) Intravenous leiomyomatosis of the uterus: a GnRH agonist utilisation before surgery. J Obstet Gynaecol 18:492–493 Clement P, Young R, Scully R (1988) Intravenous leiomyomatosis of the uterus. A clinicopathological analysis of 16 cases with unusual histologic features. Am J Surg Pathol 12:932–945 Kang LQ, Zhang B, Liu BG, Liu FH (2012) Diagnosis of intravenous leiomyomatosis extending to heart with emphasis on magnetic resonance imaging. Chin Med J (Engl) 125:33–37 Conflict of interest We declare that we have no conflict of interest. Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Mahmoud, M.S., Desai, K. & Nezhat, F.R. Leiomyomas beyond the uterus; benign metastasizing leiomyomatosis with paraaortic metastasizing endometriosis and intravenous leiomyomatosis: a case series and review of the literature. Arch Gynecol Obstet 291, 223–230 (2015). https://doi.org/10.1007/s00404-014-3356-8 Received: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s00404-014-3356-8

Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.

My notes (saved in your browser only)

Ask this paper AI returns verbatim quotes from the full text · source: oa-doi-fallback

Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works

Condition tags

endometriosis

MeSH descriptors

Endometriosis Leiomyomatosis Peritoneum Endometriosis Female Humans Hysterectomy Leiomyomatosis Lymphatic Metastasis Middle Aged Peritoneum

Citation neighborhood (sparse)

Too few in-corpus citations on either side for a chart; here are the lists.

Cites (2)

Cited by (3)

References (52)

Cited by (3)

Source provenance

europepmc
last seen: 2026-06-11T06:19:48.454388+00:00
openalex
last seen: 2026-06-04T00:00:01.174412+00:00
pubmed
last seen: 2026-05-13T22:18:22.440000+00:00
unpaywall
last seen: 2026-06-04T02:00:05.705006+00:00
License: CC0 · commercial use OK