Pancreatic metastasis of leiomyoma found 27 years after uterine fibroid surgery.
Benign metastasizing leiomyoma
Contrast-enhanced ultrasonography
Leiomyoma
Pancreatic metastasis
Uterine fibroid
Journal
Clinical journal of gastroenterology
ISSN: 1865-7265
Titre abrégé: Clin J Gastroenterol
Pays: Japan
ID NLM: 101477246
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
received:
13
04
2023
accepted:
03
08
2023
medline:
24
11
2023
pubmed:
27
8
2023
entrez:
26
8
2023
Statut:
ppublish
Résumé
A 59-year-old female was referred to our hospital for pancreatic tumor. She had undergone resection of uterine fibroids 27 years ago, and leiomyoma in the left thigh 8 years ago. Tumor markers were normal. A well-defined hypoechoic tumor measuring 26 mm × 22 mm was detected at the pancreatic tail using ultrasound. Inside the tumor, a small cystic structure was observed. High-sensitivity Doppler imaging revealed faint signals indicating blood flow from the periphery to the interior. Contrast-enhanced ultrasonography in the arterial phase revealed slow, heterogenous enhancement from the periphery to the center of the mass that occurred later than that in the pancreatic parenchyma. The tumor then exhibited homogeneous enhancement except for the periphery, with subsequent washout. Endoscopic ultrasound-fine-needle aspiration was performed. Histopathological examination diagnosed a leiomyoma. The left thigh tumor resected 8 years ago had been diagnosed as benign metastatic leiomyoma (BML). We considered that the current pancreatic tumor was also BML clinically. We report this case because pancreatic metastasis from uterine fibroids is extremely rare. Uterine fibroids are benign tumors, but there are rare cases of metastasis to various organs, which should be considered when performing ultrasound.
Identifiants
pubmed: 37632657
doi: 10.1007/s12328-023-01842-6
pii: 10.1007/s12328-023-01842-6
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
931-936Informations de copyright
© 2023. Japanese Society of Gastroenterology.
Références
Roland CF, van Heerden JA. Nonpancreatic primary tumors with metastasis to the pancreas. Surg Gynecol Obstet. 1989;168:345–7.
pubmed: 2928909
Minni F, Casadei R, Perenze B, et al. Pancreatic metastases: observations of three cases and review of the literature. Pancreatology. 2004;4:509–20.
doi: 10.1159/000080248
pubmed: 15316227
Jiang CY, Wang W, Yuan ZR. A rare pancreatic tumor in a 52-year-old Chinese woman pancreatic benign metastasizing leiomyoma. Gastroenterology. 2013;144(511):659–60.
Tuech JJ, Pessaux P, Chautard D, et al. Results of duodenopancreatectomy for solitary pancreatic metastasis from renal cell carcinoma. J Hepatobiliary Pancreat Surg. 1999;6:396–8.
doi: 10.1007/s005340050138
pubmed: 10664289
Layfield LJ, Hirschowitz SL, Adler DG. Metastatic disease to the pancreas documented by endoscopic ultrasound guided fine-needle aspiration: a seven-year experience. Diagn Cytopathol. 2012;40:228–33.
doi: 10.1002/dc.21564
pubmed: 22334524
Palmowski M, Hacke N, Satzl S, et al. Metastasis to the pancreas: characterization by morphology and contrast enhancement features on CT and MRI. Pancreatology. 2008;8:199–203.
doi: 10.1159/000128556
pubmed: 18434757
Sofuni A, Tsuchiya T, Itoi T. Ultrasound diagnosis of pancreatic solid tumors. J Med Ultrason. 2001;2020(47):359–76.
Shah S, Mortele KJ. Uncommon solid pancreatic neoplasms: ultrasound, computed tomography, and magnetic resonance imaging features. Semin Ultrasound CT MR. 2007;28:357–70.
doi: 10.1053/j.sult.2007.08.002
pubmed: 17970552
DeWitt J, Jowell P, LeBlanc J, et al. EUS-guided FNA of pancreatic metastases: a multicenter experience. Gastrointest Endosc. 2005;61:689–96.
doi: 10.1016/S0016-5107(05)00287-7
pubmed: 15855973
Sato M, Ishida H, Konno K, et al. Pancreatic metastasis: sonographic findings. Abdom Imaging. 2001;26:72–5.
doi: 10.1007/s002610000103
pubmed: 11116365
Flath B, Rickes S, Schweigert M, et al. Differentiation of a pancreatic metastasis of a renal cell carcinoma from a primary pancreatic carcinoma by echo-enhanced power Doppler sonography. Pancreatology. 2003;3:349–51.
doi: 10.1159/000071775
pubmed: 12890999
Sato T, Kato S, Watanabe S, et al. Primary leiomyoma of the pancreas diagnosed by endoscopic ultrasound-guided fine-needle aspiration. Dig Endosc. 2012;24:380.
doi: 10.1111/j.1443-1661.2011.01230.x
pubmed: 22925296
Zhang XL, Zheng RQ, Yang YB, et al. The use of contrast-enhanced ultrasound in uterine leiomyomas. Chin Med J (Engl). 2010;123:3095–9.
pubmed: 21162962
Stoelinga B, Juffermans L, Dooper A, et al. Contrast-Enhanced ultrasound imaging of uterine disorders: a systematic review. Ultrason Imaging. 2021;43:239–52.
doi: 10.1177/01617346211017462
pubmed: 34036872
pmcid: 8299780
Morohoshi T, Held G, Klopel G. Exocrine pancreas tumors and their histological classification. A study based on 167 autopsy and 97 surgical cases. Histopathology. 1983;7:645–61.
doi: 10.1111/j.1365-2559.1983.tb02277.x
pubmed: 6313514
Hackeng WM, Hruban RH, O-erhaus GJ, et al. Surgical and molecular pathology of pancreatic neoplasms. Diagn Pathol. 2016;11:47.
doi: 10.1186/s13000-016-0497-z
pubmed: 27267993
pmcid: 4897815
Ganeshan DM, Paulson E, Tamm EP, et al. Solid pseudo-papillary tumors of the pancreas: current update. Abdom Imaging. 2013;38:1373–82.
doi: 10.1007/s00261-013-0015-7
pubmed: 23775388
Baek JH, Lee JM, Kim SH, et al. Small (≦3 cm) Solid Pseudopapillary Tumors of the Pancreas at Multiphasic Multidetector CT. Radiology. 2010;257:97–106.
doi: 10.1148/radiol.10092089
pubmed: 20663966
Horiguchi Y, Suenaga M, Kurumiya T, et al. Ultrasonographic diagnosis of pancreatic neoplasm. Jpn J Med Ultrasonics. 2007;34:293–303.
doi: 10.3179/jjmu.34.293
Hashimoto S, Nakaoka K, Tanaka H, et al. Transabdominal ultrasonographic diagnosis of relatively rare pancreatic neoplasms. J Med Ultrason. 2001;2022(49):187–97.
Choe YH, Jeon SY, Lee YC, et al. Benign metastasizing leiomyoma presenting as multiple cystic pulmonary nodules: a case report. BMC Womens Health. 2017;17:81.
doi: 10.1186/s12905-017-0435-6
pubmed: 28899426
pmcid: 5596933
Yorita K, Tanaka Y, Hirano K, et al. A subserosal, pedunculated, multilocular uterine leiomyoma with ovarian tumor-like morphology and histological architecture of adenomatoid tumors: a case report and review of the literature. J Med Case Rep. 2016;10:352.
doi: 10.1186/s13256-016-1167-1
pubmed: 27998309
pmcid: 5175316
Kamat NV, Telkar HB, Ramani SK, et al. Ruptured degenerated uterine fibroid diagnosed by imaging. Obstet Gynecol. 2001;98:961–3.
pubmed: 11704222
Yanagihara T, Kobayashi N, Kawamura T, et al. Rapid enlargement of pulmonary benign metastasizing leiomyoma with fluid-containing cystic change: a case report. Surg Case Rep. 2022;8:84.
doi: 10.1186/s40792-022-01444-3
pubmed: 35508677
pmcid: 9068838
Steiner PE. Metastasizing fibroleiomyoma of the uterus. Am J Pathol. 1939;15:89–109.
pubmed: 19970436
pmcid: 1965022
Rao AV, Wilson J, Sylvester K. Pulmonary benign metastasizing leiomyoma following hysterectomy: a clinicopathologic correlation. J Thorac Oncol. 2008;3:674–6.
doi: 10.1097/JTO.0b013e3181757a46
pubmed: 18520812
Wolff M, Silva F, Kaye G. Pulmonary metastases (with admixed epithelial elements) from smooth muscle neoplasms. Report of nine cases, including three males. Am J Surg Pathol. 1979;3:325–42.
doi: 10.1097/00000478-197908000-00004
pubmed: 395847
Cho KR, Woodruff JD, Epstein JI. Leiomyoma of the uterus with multiple extrauterine smooth muscle tumors: a case report suggesting multifocal origin. Hum Pathol. 1989;20:80–3.
doi: 10.1016/0046-8177(89)90207-4
pubmed: 2912878
Bell SW, Kempson RL, Hendrickson MR. Problematic uterine smooth muscle neoplasms. A clinicopathologic study of 213 cases. Am J Surg Pathol. 1994;18:535–58.
doi: 10.1097/00000478-199406000-00001
pubmed: 8179071
Wei WT, Chen PC. Benign metastasizing leiomyoma of the lung: a case report and literature review. Oncol Lett. 2015;10:307–12.
doi: 10.3892/ol.2015.3224
pubmed: 26171020
pmcid: 4487159
Rivera JA, Christopoulos S, Small D, et al. Hormonal manipulation of benign metastasizing leiomyomas: report of two cases and review of the literature. J Clin Endocrinol Metab. 2004;89:3183–8.
doi: 10.1210/jc.2003-032021
pubmed: 15240591
Li Y, Xu T, Wang M, et al. Concurrent benign metastasizing leiomyoma in the abdominal wall and pelvic cavity: a case report and review of the literature. Front Surg. 2022;9: 842707.
doi: 10.3389/fsurg.2022.842707
pubmed: 35510124
pmcid: 9058064
Hoetzenecker K, Ankersmit HJ, Aigner C, et al. Consequences of a wait-and-see strategy for benign metastasizing leiomyomatosis of the lung. Ann Thorac Surg. 2009;87:613–4.
doi: 10.1016/j.athoracsur.2008.06.052
pubmed: 19161793
Reddy S, Wolfgang CL. The role of surgery in the management of isolated metastases to the pancreas. Lancet Oncol. 2009;10:287–93.
doi: 10.1016/S1470-2045(09)70065-8
pubmed: 19261257
Kant K, Rebala P, Rao GV, et al. Primary pancreatic leiomyosarcoma: a rare malignant transformation of primary pancreatic head leiomyoma. Cureus. 2021;13: e19328.
pubmed: 34909291
pmcid: 8653860