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. 2017 Apr 20;12(4):e0175875.
doi: 10.1371/journal.pone.0175875. eCollection 2017.

Benign metastasizing leiomyoma: A review of current literature in respect to the time and type of previous gynecological surgery

Edyta Barnaś  1 , Mariusz Książek  2 , Renata Raś  3 , Andrzej Skręt  3 , Joanna Skręt-Magierło  3 , Ewa Dmoch-Gajzlerska  4
Affiliations

Benign metastasizing leiomyoma: A review of current literature in respect to the time and type of previous gynecological surgery

Edyta Barnaś et al. PLoS One. .

Abstract

Introduction: Benign metastasizing leiomyoma (BML) is a rare disorder that affects women with a history of uterine leiomyoma, which is found to metastasise within extrauterine sites. The aetiology of BML remains unexplained. Because BML is rare, and most publications contain descriptions of single cases, no statistically determined time relations were found between the primary and secondary surgeries, which may have aetiological implications.

Objectives: To determine age before BML surgery, age during diagnosis of BML, type of prior surgery, and location of metastasis based on the literature.

Methods: A systematic review of four databases (Medline/PubMed, Embase, Web of Science, and Cochrane) covering articles published from 1 January 1965 to 10 April 2016. The inclusion criteria were full-text articles in English and articles containing case reports. Articles in languages other than English (39), articles containing incomplete data (14), i.e. no information regarding the time of surgery and/or the site of metastasis, articles bereft of case studies (25), and articles with access only to summaries, without access to the complete text (10) were excluded. Of 321 titles identified, only 126 articles met the aforementioned criteria.

Results and conclusions: The mean age during primary surgery and BML diagnosis was 38.5 years and 47.3 years, respectively. The most common surgery was total hysterectomy. The most frequent site of metastasis was the lungs; other organs were affected less frequently.The site of metastases and their number were not related to the longer time span between the patient's initial surgery and occurrence of metastasis. The analysed data, such as the age during primary surgery, age during BML diagnosis, site and type of metastasis, do not provide us a clear answer. Thus, BML pathogenesis is most probably complex in nature and requires further multidirectional research.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Number of analysed publications on BML which meet the inclusion criteria, time frame from 1960 to 10 April 2016.
Fig 2
Fig 2. Summary of retrieval and review of articles on benign metastasizing leiomyoma, 1965–2016.
Fig 3
Fig 3. BML diagnosis and the type of metastasis.
See this image and copyright information in PMC

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