Right middle lobectomy for a primary pulmonary leiomyoma: a case report

Abstract

Introduction: Primary leiomyoma of the lung is a rare benign tumor that usually presents as a solitary lesion predominantly in young females. Fewer than 100 cases have been reported. Common symptoms include fever, chronic cough, hemoptysis, chest pain, shortness of breath, and pneumonias.

Case presentation: A 34-year-old, non-smoker female who presented with recurrent pneumonias. She was found to have a primary leiomyoma of the right middle lobe. This was treated by right middle lobectomy. 6-month follow up showed patient doing well without evidence of residual disease on computerized tomography.

Conclusion: Primary pulmonary leiomyoma is a rare tumor distinct from benign metastasizing leiomyoma. Histologic features include absence of mitotic count, low cellularity, lack of cytologic atypia and pleomorphism. Treatment is by conservative surgical resection and carries a favorable prognosis.

Figure 1

Chest CT scan demonstrating pleural thickening of the inferior half of the right middle fissure with adjacent subsegmental atelectasis of the lateral segment of the right middle lobe with some air bronchograms and bronchiectasis seen within it.

Figure 2

Histopathologic slide with hematoxylin and eosin stain 20× demonstrating the abundant eosinophilic cytoplasm, oval nuclei, and inconspicuous nucleoli are appreciated. There is no cellular atypia, no vascular invasion, and no mitotic figures.