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84 MULTIPLE BENIGN MYOEPITHELIOMAS OF THE LUNG: A CASE REPORT.
  1. S. Bejjanki,
  2. K. Dowden,
  3. G. Burton
  1. Feist-Weiller Cancer Center, Louisiana State University Health Science Center, Shreveport, LA

Abstract

Background Benign myoepithelioma (ME), an uncommon soft tissue tumor, usually involves salivary glands and other soft tissue sites. Rarely, the tumor has involved the lung; however, multiple benign ME tumors involving an organ have not been reported. We describe a patient with recurrence of multiple benign myoepitheliomas involving the lung.

Case A 65-year-old female was found on routine chest x-ray to have an asymptomatic 2 cm solitary pulmonary nodule in the right upper lobe. A wedge resection was performed on 10/25/2000 with histology revealing benign spindle cells arranged in a whorled pattern. The cells were positive for both cytokeratin and smooth muscle actin, which corresponded to the presence of tonofilaments and myofilaments that were identified ultrastructurally. There was no perivascular or perineural invasion by the tumor cells and there was no significant cellular atypia or mitoses present. She did well for 4 years until a subsequent CXR demonstrated multiple lung nodules. She had no associated symptoms. CT scan of the chest demonstrated 4 noncalcified pulmonary nodules involving both lungs and measuring up to a maximum of 18 mm. Wedge resection of the right upper lobe lesion revealed benign myoepithelioma with histology and immunohistochemistry identical to the original lesion. Subsequent CT scan follow-up has demonstrated no interval change in the remaining 3 lesions.

Conclusion Myoepithelioma is a rare tumor that can recur, albeight rarely, with multiple lesions, suggesting that the tumor may have metastatic potential. Despite recurrence, it appears the tumors will follow a benign course and aggressive therapy should be limited to symptomatic patients.

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