{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T11:10:18Z","timestamp":1788952218207,"version":"build-2803163510"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Benign metastasizing leiomyoma (BML) is a rare smooth-muscle tumor that occurs in patients with a history of uterine leiomyoma, with the lungs being the most commonly involved extrauterine site. Pulmonary BML can mimic metastatic malignancy on imaging. Decades-long intervals after uterine surgery have been reported, and\n                      <jats:sup>18<\/jats:sup>\n                      F-FDG uptake may vary among lesions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>\n                      A 59-year-old postmenopausal, nonsmoking woman presented with multiple bilateral pulmonary nodules 30 years after hysterectomy for uterine leiomyoma.\n                      <jats:sup>18<\/jats:sup>\n                      F-FDG PET\/CT demonstrated mild FDG uptake in the dominant pulmonary lesion, with a maximum standardized uptake value (SUVmax) of 2.44. Although the uptake was not strongly suggestive of an aggressive malignancy, a low-grade neoplasm could not be excluded. Video-assisted thoracoscopic wedge resection was therefore performed. Histological examination revealed bland spindle-cell proliferation arranged in fascicles, with mitotic activity of &amp;lt; 1 per 10 high-power fields and a Ki-67 labeling index of approximately 2%. The spindle cells expressed desmin, vimentin, and estrogen receptor, whereas focal TTF-1 staining was restricted to entrapped bronchial epithelial cells. In conjunction with the bilateral multifocal pulmonary distribution and remote history of uterine leiomyoma, these findings supported a clinicopathological diagnosis of pulmonary BML. The patient recovered uneventfully without endocrine therapy. During postoperative telephone follow-up, she reported no new discomfort, and regular chest CT surveillance was recommended.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Pulmonary BML should be considered in the differential diagnosis of multiple pulmonary nodules in women with a remote history of uterine leiomyoma. Mild FDG uptake cannot distinguish pulmonary BML from a low-grade malignancy. Integrated clinical, radiological, and pathological assessment is therefore required to establish the diagnosis and avoid unnecessary treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1934720","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T10:16:24Z","timestamp":1788948984000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Pulmonary benign metastasizing leiomyoma with mild 18F-FDG uptake occurring 30 years after hysterectomy"],"prefix":"10.3389","volume":"16","author":[{"given":"Huifeng","family":"Zou","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, The Affiliated Hospital of Jiangsu University","place":["Zhenjiang, Jiangsu, China"]},{"name":"School of Medicine, Jiangsu University","place":["Zhenjiang, Jiangsu, 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