METASTASIZING UTERINE LEIOMYOMA - A CASE WITH CARDIAC AND PULMONARY METASTASIS

A case of histologically benign cardiac and pulmonary metastases from a uterine leiomyoma in a 45-year-old woman is reported. The solitary c ardiac tumor consisted of five lobules with a stalk attached to the an terior papillary muscle of the right ventricle, which occupied the rig ht ventricular cavity and almost completely obstructed the pulmonary m ain trunk in the systolic cycle. Multiple small nodules were found thr oughout both lungs. The cardiac tumor was resected at open heart surge ry and open lung biopsy of the pulmonary lesion was simultaneously per formed. Both of them were histologically identical to the apparently h istologically benign uterine leiomyoma which had been resected Jive ye ars previously Based on the clinical and laboratory findings, it is po stulated that antegrade metastases via the venous system resulted in t he cardiac metastasis from the uterine leiomyoma and the secondary pul monary metastasis from the cardiac tumor. In contrast to the light mic roscopic findings, ultrastructural examination suggested the possibili ty of malignancy associated with the presence of immature smooth muscl e cells. This is the first reported case of a so-called benign metasta sizing leiomyoma occurring in the heart.