Surgical case reports · 2026
A Case of Primary Leiomyoma of the Chest Wall Showing High Uptake on FDG-PET.
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Sakaguchi Takuzo, Takahashi Mamoru, Cho Shunji, Shoji Tsuyoshi, Katakura Hiromichi
Аннотация
INTRODUCTION: Primary leiomyoma of the chest wall is a rare entity. We report a case of primary chest wall leiomyoma with intense uptake on fluorodeoxyglucose PET (FDG-PET), requiring differentiation from malignancy.
CASE PRESENTATION: An 82-year-old man with a history of asbestos exposure underwent annual chest CT surveillance. A 19-mm nodule was newly identified on the right chest wall and had not been present on CT the previous year. Although the lesion had well-defined margins on CT, FDG-PET demonstrated intense uptake with a maximum standardized uptake value of 11.8, raising suspicion for malignancy. Surgical resection was performed for diagnostic and therapeutic purposes. Histopathological examination revealed fascicular proliferation of spindle-shaped cells. Immunohistochemical analysis suggested a smooth muscle tumor, and retention of BRCA1-associated protein 1 and methylthioadenosine phosphorylase excluded mesothelioma. Based on these findings, the tumor was diagnosed as a primary leiomyoma of the chest wall.
CONCLUSIONS: Primary leiomyomas of the chest wall are rare and may show high FDG uptake on PET imaging, making differentiation from malignant tumors challenging. A comprehensive evaluation incorporating imaging, intraoperative findings, and pathological assessment is essential for accurate diagnosis.
CASE PRESENTATION: An 82-year-old man with a history of asbestos exposure underwent annual chest CT surveillance. A 19-mm nodule was newly identified on the right chest wall and had not been present on CT the previous year. Although the lesion had well-defined margins on CT, FDG-PET demonstrated intense uptake with a maximum standardized uptake value of 11.8, raising suspicion for malignancy. Surgical resection was performed for diagnostic and therapeutic purposes. Histopathological examination revealed fascicular proliferation of spindle-shaped cells. Immunohistochemical analysis suggested a smooth muscle tumor, and retention of BRCA1-associated protein 1 and methylthioadenosine phosphorylase excluded mesothelioma. Based on these findings, the tumor was diagnosed as a primary leiomyoma of the chest wall.
CONCLUSIONS: Primary leiomyomas of the chest wall are rare and may show high FDG uptake on PET imaging, making differentiation from malignant tumors challenging. A comprehensive evaluation incorporating imaging, intraoperative findings, and pathological assessment is essential for accurate diagnosis.