Challenges in the diagnosis and treatment of extrauterine leiomyomas: case series


  • Yafang Tang Department of Obstetrics and Gynaecology, K. K. Women’s and Children’s Hospital, Singapore
  • Ravichandran Nadarajah Department of Gynaecological Oncology, Singapore General Hospital, Singapore



Extrauterine leiomyoma, Metastasis, Diagnosis, Treatment


Extrauterine leiomyoma is a rare disease with multiple potential metastasizing sites. Pathogenesis of this condition remains debatable with previous myomectomy a considerable risk factor. Diagnosis and treatment remain a challenge due to diverse presenting symptoms and the initial involvement of various specialties, which often cause distress in these patients. In this article, we present one case of pulmonary leiomyomas on expectant management, one case of wide-disseminated extrauterine leiomyomas including the bones, spines, soft tissues and peritoneum who underwent decompression laminectomy and biopsy of paravertebral mass and one case of retroperitoneal leiomyoma who underwent resection of the lesion.


Khan AT, Shehmar M, Gupta JK. Uterine fibroids: current perspectives. Int J Womens Health. 2014; 6:95-114

Raś R, Książek M, Barnaś E. Benign metastasizing leiomyoma in triple location: lungs, parametria and appendix. Prz Menopauzalny. 2016; 15:117-21.

Kim YN, Eoh KJ, Lee JY. Aberrant uterine leiomyomas with extrauterine manifestation: intravenous leiomyomatosis and benign metastasizing leiomyomas. Obstet Gynecol Sci. 2018;61:509-519.

Nasu K, Tsuno A, Takai N, Narahara H. A case of benign metastasizing leiomyoma treated by surgical castration followed by an aromatase inhibitor, anastrozole. Arch Gynecol Obstet. 2009;279:255-7.

Barnaś E, Książek M, Raś R, Skręt A, Skręt-Magierøo J, Dmoch-Gajzlerska E. Benign metastasizing leiomyoma: A review of current literature in respect to the time and type of previous gynecological surgery. PLOS ONE. 2017;12: e0175875.

Wei WT, Chen PC. Benign metastasizing leiomyoma of the lung: A case report and literature review. Oncol Lett. 2015;10:307-12.

Usman Y, Iftikhar O, Ishaq MK, Awab A. Pulmonary benign metastasizing leiomyoma, why metastasizes if benign. Chest. 2015;148:627A.

Hoynck van Papendrecht HP, Gratama S. Leiomyomatosis peritoneal is disseminata. Eur J Obstet Gynecol Reprod Biol. 1983;14:251-259.

Wentling GK, Sevin BU, Geiger XJ, Bridges MD. Benign metastasizing leiomyoma responsive to megestrol: case report and review of the literature. Int J Gynecol Cancer. 2005;15:1213-7.

Hassan MH, Eyzaguirre E, Arafa HM, Hamada FMA, Salama SA, Al-Hendy A. Memy I. a novel murine model for uterine leiomyoma using adenovirus enhanced human fibroid explants in severe combined immune deficiency mice. Am J Obstet Gynecol. 2008;199:156.e1-8.

Rader JS, Binette SP, Brandt TD, Sreekanth S, Chhablani A. Ileal hemorrhage caused by a parasitic uterine leiomyoma. Obstet Gyneco.l 1990;76:531-4.

Cucinella G, Granese R, Calagna G, Somigliana E, Perino A. Parasitic myomas after laparoscopic surgery: an emerging complication in the use of morcellator? Description of four cases. Fertil Steril. 2011;96:e90-6.

Miller J, Shoni M, Siegert C, Lebenthal A, Godleski J, McNamee C. Benign Metastasizing Leiomyomas to the Lungs: An institutional case series and a review of the recent literature. Ann Thorac Surg. 2016;101:253-8.

Mogi A, Hirato J, Kosaka T, Yamaki E, Kuwano H. Benign metastasizing leiomyoma of the lung: report of a case. Gen Thorac Cardiovasc Surg. 2013;61: 719-22.

Bakkensen JB, Samore W, Bortoletto P, Morton CC, Anchan R. Pelvic and pulmonary benign metastasizing leiomyoma: A case report. Case Rep Women Health. 2018;18:e00061.






Case Series