Novel Hormone Treatment of Benign Metastasizing Leiomyoma: an Analysis of Five Cases and Literature Review

Overview

Journal Fertil Steril

Specialty Reproductive Medicine

Date 2013 Mar 8

PMID 23465706

Citations 38

Authors

Erin I Lewis

Rebecca J Chason

Alan H DeCherney

Alicia Armstrong

John Elkas

Aradhana M Venkatesan

Affiliations

Soon will be listed here.

Abstract

Objective: To evaluate novel hormonal therapies in patients with unresectable benign metastasizing leiomyoma (BML) disease.

Design: Case series.

Setting: National Institutes of Health (NIH).

Patient(s): Five subjects with the diagnosis of BML based on imaging and/or histopathologic diagnosis.

Intervention(s): Four patients were treated with single or combination therapy of leuprolide acetate and/or an aromatase inhibitor. One patient was treated with an antiprogestin (CDB-2914).

Main Outcome Measure(s): Response to therapy was measured by tumor burden on cross-sectional imaging employing RECIST (Response Evaluation Criteria in Solid Tumors) 1.1 guidelines.

Result(s): Four patients treated with single or combination therapy of leuprolide acetate and/or an aromatase inhibitor demonstrated stable disease with reduction in tumor burden. The fifth patient treated with antiprogestin (CDB-2914) had degeneration of her tumor, progression of its size, and an improvement in symptoms.

Conclusion(s): Hormone treatment with GnRH agonist and/or aromatase inhibition may be a therapeutic option to reduce tumor burden in unresectable BML disease or for those patients who wish to avoid surgical intervention. RECIST 1.1 guidelines, while traditionally used to evaluate tumor response to cancer therapeutics, may be useful in evaluating BML tumor burden response to hormone therapy.

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References

Bodner-Adler B, Bartl M, Wagner G . Intravenous leiomyomatosis of the uterus with pulmonary metastases or a case with benign metastasizing leiomyoma?. Anticancer Res. 2009; 29(2):495-6. View

Egberts J, Schafmayer C, Bauerschlag D, Janig U, Tepel J . Benign abdominal and pulmonary metastasizing leiomyoma of the uterus. Arch Gynecol Obstet. 2006; 274(5):319-22. DOI: 10.1007/s00404-006-0165-8. View

Palomba S, Orio Jr F, Russo T, Falbo A, Tolino A, Lombardi G . Antiproliferative and proapoptotic effects of raloxifene on uterine leiomyomas in postmenopausal women. Fertil Steril. 2005; 84(1):154-61. DOI: 10.1016/j.fertnstert.2004.12.058. View

STEINER P . Metastasizing fibroleiomyoma of the uterus: Report of a case and review of the literature. Am J Pathol. 2009; 15(1):89-110.7. PMC: 1965022. View

Pathak A, Pacificar J, Shapiro C, Williams S . Determining dosing intervals for luteinizing hormone releasing hormone agonists based on serum testosterone levels: a prospective study. J Urol. 2007; 177(6):2132-5. DOI: 10.1016/j.juro.2007.01.157. View

Motegi M, Takayanagi N, Sando Y, Ubukata M, Imai S, Suzuki T . [A case of so-called benign metastasizing leiomyoma responsive to progesterone]. Nihon Kyobu Shikkan Gakkai Zasshi. 1993; 31(7):890-5. View

Kayser K, Zink S, Schneider T, Dienemann H, Andre S, Kaltner H . Benign metastasizing leiomyoma of the uterus: documentation of clinical, immunohistochemical and lectin-histochemical data of ten cases. Virchows Arch. 2000; 437(3):284-92. DOI: 10.1007/s004280000207. View

Stephenson C, Henley F, Goldstein A . Benign metastasizing leiomyoma. Ala J Med Sci. 1984; 21(1):78-81. View

Bayya J, Minkoff H, Khulpateea N . Tamoxifen and growth of an extrauterine leiomyoma. Eur J Obstet Gynecol Reprod Biol. 2008; 141(1):90-1. DOI: 10.1016/j.ejogrb.2008.07.001. View

10.

Taveira-DaSilva A, Alford C, Levens E, Kotz H, Moss J . Favorable response to antigonadal therapy for a benign metastasizing leiomyoma. Obstet Gynecol. 2012; 119(2 Pt 2):438-442. PMC: 3266540. DOI: 10.1097/AOG.0b013e318240090e. View

11.

Beck M, Biswas B, Dsouza A, Kumar R . Benign metastasising leiomyoma after hysterectomy and bilateral salpingo-oophorectomy. Hong Kong Med J. 2012; 18(2):153-5. View

12.

Cohen J, Robins H . Response of "benign" metastasizing leiomyoma to progestin withdrawal. Case report. Eur J Gynaecol Oncol. 1993; 14(1):44-5. View

13.

Eisenhauer E, Therasse P, Bogaerts J, Schwartz L, Sargent D, Ford R . New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer. 2008; 45(2):228-47. DOI: 10.1016/j.ejca.2008.10.026. View

14.

Ingle J, Buzdar A, Schaid D, Goetz M, Batzler A, Robson M . Variation in anastrozole metabolism and pharmacodynamics in women with early breast cancer. Cancer Res. 2010; 70(8):3278-86. PMC: 2855746. DOI: 10.1158/0008-5472.CAN-09-3024. View

15.

Hague W, Abdulwahid N, Jacobs H, Craft I . Use of LHRH analogue to obtain reversible castration in a patient with benign metastasizing leiomyoma. Br J Obstet Gynaecol. 1986; 93(5):455-60. View

16.

Awonuga A, Shavell V, Imudia A, Rotas M, Diamond M, E Puscheck E . Pathogenesis of benign metastasizing leiomyoma: a review. Obstet Gynecol Surv. 2010; 65(3):189-95. DOI: 10.1097/OGX.0b013e3181d60f93. View

17.

Hekster R, Lambooy N, van Hall E, Kazzaz B, van Rijssel E . Hormone-dependent spinal leiomyoma. Surg Neurol. 1994; 41(4):330-3. DOI: 10.1016/0090-3019(94)90185-6. View

18.

Shin M, Fulmer J, Ho K . Unusual computed tomographic manifestations of benign metastasizing leiomyomas as cavitary nodular lesions or interstitial lung disease. Clin Imaging. 1996; 20(1):45-9. DOI: 10.1016/0899-7071(94)00076-x. View

19.

Maheux R, Samson Y, Farid N, Parent J, Jean C . Utilization of luteinizing hormone-releasing hormone agonist in pulmonary leiomyomatosis. Fertil Steril. 1987; 48(2):315-7. DOI: 10.1016/s0015-0282(16)59362-5. View

20.

Espada Vaquero M, Magrina J, Leslie K . Uterine smooth-muscle tumors with unusual growth patterns. J Minim Invasive Gynecol. 2009; 16(3):263-8. DOI: 10.1016/j.jmig.2009.01.013. View