Spontaneous transient size reduction of a solitary pulmonary metastasis from a leiomyosarcoma

Abstract Background A solitary pulmonary nodule (SPN) poses a diagnostic challenge, which includes both a benign and malignant etiology. A size enlargement often indicates malignancy. We herein describe a case of a solitary pulmonary metastasis from a leiomyosarcoma that regressed transiently during...

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Main Authors: Nao Ito, Shuhei Iizuka, Kanji Sasaki, Yoshiro Otsuki, Toru Nakamura
Format: Article
Language:English
Published: Japan Surgical Society 2023-01-01
Series:Surgical Case Reports
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Online Access:https://doi.org/10.1186/s40792-023-01591-1
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author Nao Ito
Shuhei Iizuka
Kanji Sasaki
Yoshiro Otsuki
Toru Nakamura
author_facet Nao Ito
Shuhei Iizuka
Kanji Sasaki
Yoshiro Otsuki
Toru Nakamura
author_sort Nao Ito
collection DOAJ
description Abstract Background A solitary pulmonary nodule (SPN) poses a diagnostic challenge, which includes both a benign and malignant etiology. A size enlargement often indicates malignancy. We herein describe a case of a solitary pulmonary metastasis from a leiomyosarcoma that regressed transiently during follow-up. Case presentation A 47-year-old woman presented with an SPN detected by follow-up computed tomography 7 years after surgery for a left forearm high-grade leiomyosarcoma. The nodule regressed spontaneously after an additional 6 months, and therefore, an inflammatory change was the most likely diagnosis at that time. However, the nodule enlarged again over the next 5 years. The growth rate led us to suspect a malignancy. A trans-bronchial biopsy was undiagnostic and a video-assisted thoracic surgery was planned. She underwent a wedge resection of the right lung, and a histopathological examination found it was a metastatic leiomyosarcoma. Conclusions A pulmonary metastasis from a leiomyosarcoma could emerge as an SPN and reveal a subsequent transient size reduction. An SPN in patients even with a remote history of a soft tissue tumor should raise the possibility of metastasis, and periodic follow-up is essential even after the size reduction.
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spelling doaj-art-c8409c9271ab492c9c45ccebe3a9ba792025-08-20T03:39:10ZengJapan Surgical SocietySurgical Case Reports2198-77932023-01-01911410.1186/s40792-023-01591-1Spontaneous transient size reduction of a solitary pulmonary metastasis from a leiomyosarcomaNao Ito0Shuhei Iizuka1Kanji Sasaki2Yoshiro Otsuki3Toru Nakamura4Department of General Thoracic Surgery, Seirei Hamamatsu General HospitalDepartment of General Thoracic Surgery, Seirei Hamamatsu General HospitalDepartment of Orthopedic Surgery, Seirei Hamamatsu General HospitalDepartment of Pathology, Seirei Hamamatsu General HospitalDepartment of General Thoracic Surgery, Seirei Hamamatsu General HospitalAbstract Background A solitary pulmonary nodule (SPN) poses a diagnostic challenge, which includes both a benign and malignant etiology. A size enlargement often indicates malignancy. We herein describe a case of a solitary pulmonary metastasis from a leiomyosarcoma that regressed transiently during follow-up. Case presentation A 47-year-old woman presented with an SPN detected by follow-up computed tomography 7 years after surgery for a left forearm high-grade leiomyosarcoma. The nodule regressed spontaneously after an additional 6 months, and therefore, an inflammatory change was the most likely diagnosis at that time. However, the nodule enlarged again over the next 5 years. The growth rate led us to suspect a malignancy. A trans-bronchial biopsy was undiagnostic and a video-assisted thoracic surgery was planned. She underwent a wedge resection of the right lung, and a histopathological examination found it was a metastatic leiomyosarcoma. Conclusions A pulmonary metastasis from a leiomyosarcoma could emerge as an SPN and reveal a subsequent transient size reduction. An SPN in patients even with a remote history of a soft tissue tumor should raise the possibility of metastasis, and periodic follow-up is essential even after the size reduction.https://doi.org/10.1186/s40792-023-01591-1Solitary pulmonary noduleLeiomyosarcomaPulmonary metastasis
spellingShingle Nao Ito
Shuhei Iizuka
Kanji Sasaki
Yoshiro Otsuki
Toru Nakamura
Spontaneous transient size reduction of a solitary pulmonary metastasis from a leiomyosarcoma
Surgical Case Reports
Solitary pulmonary nodule
Leiomyosarcoma
Pulmonary metastasis
title Spontaneous transient size reduction of a solitary pulmonary metastasis from a leiomyosarcoma
title_full Spontaneous transient size reduction of a solitary pulmonary metastasis from a leiomyosarcoma
title_fullStr Spontaneous transient size reduction of a solitary pulmonary metastasis from a leiomyosarcoma
title_full_unstemmed Spontaneous transient size reduction of a solitary pulmonary metastasis from a leiomyosarcoma
title_short Spontaneous transient size reduction of a solitary pulmonary metastasis from a leiomyosarcoma
title_sort spontaneous transient size reduction of a solitary pulmonary metastasis from a leiomyosarcoma
topic Solitary pulmonary nodule
Leiomyosarcoma
Pulmonary metastasis
url https://doi.org/10.1186/s40792-023-01591-1
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AT kanjisasaki spontaneoustransientsizereductionofasolitarypulmonarymetastasisfromaleiomyosarcoma
AT yoshirootsuki spontaneoustransientsizereductionofasolitarypulmonarymetastasisfromaleiomyosarcoma
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