Abstract
Pulmonary leiomyoma has a diverse clinical spectrum of disease. Here we describe two patients with vastly different presentations. The first case is a 23-year-old female with a chronic cough and no visible tracheal lesion on computer tomography (CT) chest imaging. Flexible bronchoscopy revealed a small tracheal nodule, with histopathology confirming pulmonary leiomyoma. The second case is a 57-year-old female with a painless abdominal mass. CT imaging revealed widespread lung 'cannonball' nodules. Percutaneous biopsy confirmed metastatic leiomyoma. After progression on surveillance and endocrine therapy, she was commenced on doxorubicin with interval radiological improvement. These cases highlight the clinical heterogeneity in this disease, and thus, complexity in devising standardized diagnostic and therapeutic protocols.