Type:
Educational Exhibit
Keywords:
Abdomen, CT, Contrast agent-intravenous, Cancer
Authors:
D. Paul, M. Feeney
DOI:
10.26044/ranzcr2022/R-0015
Imaging findings OR Procedure details
A 55‐year‐old female presented with menorrhagia for 4 weeks. Dilation and curettage suggested grade 1 endometrial cancer. Computed tomography (CT) of the abdomen and pelvis did not demonstrate abdominopelvic nodes, but multiple lesions in the lung bases. The patient was planned for a CT-guided biopsy of the presumed lung metastases. However, the non-contrast planning CT chest revealed a large well-circumscribed anterior mediastinal soft tissue mass with central calcifications, which was not captured on the CTAP. Following the biopsy, the PET scan revealed diffuse uptake in the anterior mediastinal mass. There was nil significant uptake in the presumed lung metastases with focal uptake in the posterior and inferior uterus raising the suspicion of an uterine adenocarcinoma. Mediastinomy and biopsy demonstrated benign appearing lymphoid tissue with proliferation and nil mitotic features, suggesting a reactive process. The biopsy confirmed benign metastasizing leiomyoma (BML) in the lungs within the setting of malignant uterine adenocarcinoma and an unknown mediastinal mass demonstrating two synchronous yet separate intrathoracic pathologies independent of the uterine malignancy.