We herein present 2 cases of metastatic lung
tumor derived from uterine
leiomyosarcoma. In the case 1, a 59-year-old woman was admitted to our hospital to examine abnormal shadow detected on chest X-ray. She had undergone
hysterectomy and
oophorectomy for uterine
leiomyosarcoma 19 months previously. A round 3 cm mass in the right lung (S10) was seen on chest X-ray and computed tomography (CT). No other distant
metastases or local recurrence were found, and the right lower lobectomy was perfomed under the clinical diagnosis of metastatic lung
tumor. Postoperative pathologic examination revealed the
tumor as a metastatic
leiomyosarcoma. The patient recovered uneventfully, and there have been no signs of recurrence for 26 months after the pulmonary resection. In the case 2, a 58-year-old woman, who had undergone
hysterectomy and
oophorectomy for uterine
leiomyosarcoma 7 months previously, was admitted to our hospital for further examination of pulmonary
tumors on chest X-ray. Two
tumors were recognized in the left lung (S8 and S10) on chest X-ray and CT. No other distant
metastases or local recurrence were found, and the left lower lobectomy was performed under the clinical diagnosis of metastatic lung
tumors. Pathological examinations revealed smooth muscle cells with nuclear pleomorphism and high mitotic indices. The
tumors proved to be lung
metastases derived from uterine
leiomyosarcoma. Postoperative course was uneventful. However, brain
metastasis was found 1 month after the pulmonary resection, and she underwent resection of brain
metastasis. Two months after the brain
metastasectomy, local recurrence of the
brain tumor developed and re-resection followed by stereotactic
radiotherapy was performed. Furthermore, intrapelvic recurrence was found 4 months after the pulmonary resection. Exploratory
laparotomy revealed the
tumor was unresectable, and she received 4 courses of
chemotherapy (
paclitaxel and
carboplatin). For metastatic lung
tumor from uterine
leiomyosarcoma, surgery has been considered the best choice. However, for patients with uterine
leiomyosarcoma who cannot be treated surgically because of multiple metastatic
tumors or poor surgical risk
chemotherapy (
paclitaxel and
carboplatin) or stereotactic
radiotherapy can be strategies.