Léiomyome bénin métastatique : localisation simultanée prépéritonéale et pulmonaire

Benign metastasizing leiomyoma (BML) is a rare manifestation of a uterine léiomyoma, where smooth muscle cells metastasize to distant sites. We report a case of a BML with simultaneous metastasis to the lung and preperitoneal space in a 45-year-old patient with a history of myomectmy, who suffered from pelvic pain and weight loss. Imaging revealed a pelvic preperitoneal mass with multiple bilateral pulmonary nodules. Image guided biopsy from both the pelvic and the lung lesion was reported as leiomyoma, then the patient had a surgical excision of the tumor with total abdominal hysterectomy and bilateral oophorectomy. Histological examination of the surgical specimen concluded to leiomyoma. Mitotic index was about 2/10 HPF. Proliferation index (Ki67) was less than 2-3%. The evolution was good without recurrence after 3 years and pulmonary lesions are remaining the same. A BML simultaneously involving lung and preperitoneal space is a rarely encountered condition, which can misdiagnose metastasis or other malignant diseases. BML should be included in the differential diagnosis when image findings, similar to those of ordinary leiomyomas are noted, in patients with a history of uterine leiomyoma.