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Case Reports in Emergency Medicine
Volume 2015, Article ID 278020, 5 pages
Case Report

An Unusual Cause of Pulmonary Nodules in the Emergency Department

1Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada L8S 4L8
2Department of Diagnostic Imaging, Juravinski Hospital and Cancer Centre and McMaster University, Hamilton, ON, Canada L8V 5C2

Received 8 November 2014; Revised 3 February 2015; Accepted 3 February 2015

Academic Editor: Chih Cheng Lai

Copyright © 2015 Ryan Yu and Melanie Ferri. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


We report a 51-year-old woman who presented to the emergency department with left-sided pleuritic chest pain 2 weeks after subtotal hysterectomy and bilateral salpingo-oophorectomy for a leiomyomatous uterus. Computed tomography scan of the chest revealed bilateral pulmonary nodules. Biopsy showed cytologically bland spindle cells without overt malignant features. Immunohistochemistry confirmed smooth muscle phenotype, in keeping with a clinicopathologic diagnosis of benign metastasizing leiomyoma (BML). BML does not frequently come to the attention of the emergency physician because it is rare and usually asymptomatic. When symptomatic, its clinical presentation depends on the site(s) of metastasis, number, and size of the smooth muscle tumors. Emergent presentations of BML are reviewed.