Benign Metastasizing Leiomyomas Involving Multiple Pelvic and Para-Aortic Lymph Nodes: A Case Report

Benign Metastasizing Leiomyomas Involving Multiple Pelvic and Para-Aortic Lymph Nodes: A Case Report

A 45-year old lady presented with vague abdominal discomfort of 2 weeks duration. She gave a past history of hysterectomy for fibroid. Per vaginal examination detected a large mass in right pelvis. A radiological examination confirmed the mass. Multiple enlarged internal nodes were also detected radiologically. A guided biopsy was done which on histopathology showed bland spindle cells. The patient was taken up for surgery and resection of the masses were done. Bilateral ovaries along with fallopian tubes were also identified and resected. Histopathological examination showed the resected masses to be lymph nodes with benign spindle cell neoplasm. The spindle cells were positive for SMA, PR and were negative for HMB 45, Ckit and DOG 1. MIB-1 proliferation index was low. Based on histopathological and immunohistochemical findings and previous clinical history a diagnosis of benign metastasizing leiomyoma (BML) was made. BML is a relatively rare disease. There are few reports about lymph node metastasis in BML. However, multiple pelvic and para-aortic lymph node metastases such as in our case are quite rare and hence we are reporting this case.