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V. Franciosi
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P3.01 - Poster Session with Presenters Present (ID 469)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Biology/Pathology
- Presentations: 1
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
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P3.01-004 - Exceptional Evolution of Benign Metastasizing Leiomyomas of the Lung (ID 4028)
14:30 - 14:30 | Author(s): V. Franciosi
- Abstract
Background:
to describe an exceptional case of malignant transformation of benign metastasizing leiomyomas (BML) of the lung.
Methods:
a 62-year-old woman presented for radiological finding of multiple bilateral pulmonary nodules. Nine years before, she underwent hysterectomy for uterine leiomyoma. After pulmonary biopsy, a diagnosis of BML was made. Subsequently, a surgical resection of the right pulmonary nodules was performed; histopathological examinations confirmed the diagnosis of BML (Ki67=1%; strong expression of estrogen and progesterone receptor as depicted in Fig.1C-E). The patient was put on anastrazole therapy but an increase of the left pulmonary nodules was observed. Therefore, a surgical resection of the left nodules was carried out; final pathological examination confirmed BML. Three years later, a chest CT-scan showed bilateral pulmonary relapses; tamoxifen was started but it was ineffective. Then, a surgical resection of the right pulmonary nodules was performed (Fig.1A-B). The patient was discharged uneventfully on postoperative day 5.
Results:
macroscopically, the nodules had whitish and yellowish colour, smooth margins, with tense-elastic consistency. Microscopically, an intersecting bundles of spindle cells with moderate nuclear atypia organized in a fascicular pattern were clearly evident (Fig.1F). The mitotic activity was more pronounced than previous histological samples (up to 10 mitoses/10HPF). Immunohistochemical studies showed positivity for smooth-muscle actin, desmin, and negativity for HMB-45, CD34, and TTF-1; Ki-67=20% (Fig.1G). Estrogen and progesterone receptor were weakly positive (Fig.1H). Based on the current criteria, a diagnosis of low-grade leiomyosarcoma was made. The patient denied the contralateral surgical resection. Eighteen months later the chest CT-scan revealed bilateral pulmonary nodules; she is currently under megesterol acetate treatment. Figure 1
Conclusion:
BML of the lung is a rare pathological condition with a usually indolent clinical course. Although it’s exceptional, an evolution towards a low grade leiomyosarcoma should be considered in the natural history of the disease.
