Background: Extrauterine fibroids are rare and are usually difficult to diagnose. Benign metastasizing leiomyomatosis (BML) is characterized by multiple smooth-muscle nodules located on the peritoneum, omentum, or rest of peritoneal surface. Case: A 42-year-old woman presented for a routine gynecologic examination; an ultrasound revealed that she had a fibroid in her uterus and an endometriotic cyst. Intraoperatively, it was noted that she had a chocolate cyst of the left ovary and multiple fibroids on her uterus, broad ligament, sigmoid colon, omentum, and liver surface. She underwent excision of all these fibroids. She was also advised to undergo computed tomography (CT) to check for lesions in her lungs. A few lesions were noted. She was treated with letrozole postoperatively. Results: Follow-up at 15 months showed no evidence of recurrence. She had a repeat CT scan of her thorax, which showed no increase in the size of the lesions in her lungs. Conclusions: Aromatase inhibitors can be used successfully to treat benign metastasizing leiomyomatosis. Further reports are also needed to find the role of aromatase inhibitors in BML. (J GYNECOL SURG 32:193)
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