Benign metastasising leiomyoma after hysterectomy and bilateral salpingo-oophorectomy

Benign metastasising leiomyomatosis is a rare condition affecting women in the reproductive age-group with a history of uterine fibroids, who have undergone treatment by myomectomy or hysterectomy. It is characterised by development of multiple, indolent, smooth muscle tumours outside the uterus, most commonly in the lungs, and manifests several years after the uterine surgery. We describe the case of a young woman, who had undergone total abdominal hysterectomy and bilateral salpingo-oophorectomy for multiple fibroids and a right ovarian cyst. After 5 years of being on oestrogen replacement therapy, she was detected to have benign metastasising leiomyoma, for which an additional laparotomy was performed. At laparotomy, removal of the pelvic mass was associated with several complications. The metastatic lesions in the lung responded well to progestogens (megestrol acetate) alone as evidenced by regression of the lesions detected at follow-up after 6 months and 1 year.