CTICasesCystic Metastases from Endometrial Stromal Sarcoma
Imaging findings
Chest CT shows several large, stable, thin-walled cystic spaces in a perivascular distribution, resembling lymphangiomyomatosis or lymphoid interstitial pneumonia. Review of a PET/CT from five years prior reveals these cysts correspond to previously solid, highly hypermetabolic metastases from endometrial stromal sarcoma that cavitated and evacuated following therapy, remaining stable as empty cysts for years.
Key takeaways
Cavitary and cystic pulmonary metastases are known to occur with certain malignancies, including sarcomas (such as endometrial stromal sarcoma) and squamous cell carcinomas. Following successful treatment, solid metastases can undergo necrosis, excavate, and persist as thin-walled cystic spaces. Recognizing this history is essential to prevent misdiagnosing these stable cysts as benign cystic lung disease.
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