A Woman in Her Forties with Six Months of Worsening Dyspnea

Dilpat Kumar, M. Nguyen, S. Kenth, F. Warsha
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Abstract

Uterine leiomyosarcoma (ULMS) is a rare cancer that originates from the smooth muscle of the uterine wall. ULMS is aggressive with a high rate of recurrence and mortality. Although the majority of ULMS are initially diagnosed within the uterus, they possess a high metastatic potential. Two thirds of metastatic ULMS sites involve the lung. However, the clinical presentations of such metastases are surprisingly not well described. In this case, we describe a case of a woman in her forties who presented with 6 months of worsening dyspnea and chronic cough. Her pulmonary function test demonstrated severe restrictive lung disease. Computed tomography (CT) of the chest was done which showed multiple pulmonary nodules. CT abdomen and pelvis identified multiple uterine masses with largest being 17 cm. Biopsy of uterine masses confirmed the diagnosis of UMLS. Her restrictive lung disease was diagnosed to be secondary to UMLS, as patient had no other identifiable risk factors.
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一名四十多岁的妇女,呼吸困难恶化六个月
子宫平滑肌肉瘤(ULMS)是一种起源于子宫壁平滑肌的罕见癌症。ULMS具有侵袭性,复发率和死亡率高。虽然大多数ULMS最初是在子宫内诊断出来的,但它们具有很高的转移潜力。三分之二的ULMS转移部位累及肺部。然而,令人惊讶的是,这种转移的临床表现并没有得到很好的描述。在这个病例中,我们描述了一个40多岁的女性,她出现了6个月恶化的呼吸困难和慢性咳嗽。肺功能检查显示她患有严重的限制性肺病。胸部计算机断层扫描显示多发肺结节。腹部及骨盆CT示子宫多发肿块,最大17cm。子宫肿块活检证实了UMLS的诊断。她的限制性肺部疾病被诊断为继发于UMLS,因为患者没有其他可识别的危险因素。
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