Patient: Description of the condition (time of onset, main symptoms, hospital visited, etc.): The patient is female, 39 years old, and is currently in good health. 1. On May 22, 2010, a CT examination revealed three shadows in the lungs due to a cough that had not improved for more than a month. 2.On May 26 and 31, 2010, puncture and branched fibrinoscopy confirmed smooth muscle sarcoma (see attached for test results). 3.On June 8, 2010, a whole body PET-CT was done (results are attached), and in addition to the lung, a fibroid was found in the uterus, which was actually known to the patient in October 2009. All other parts of the body showed normal. Previous treatment and results: 1. A fibroid removal was done in May 2007, and the test result was benign at that time. 2.The patient had a PET-CT examination in Hunan Cancer Hospital in September 2008 and found a shadow negative in the lung, but no treatment measures were taken, and the doctor only suggested a review in six months. 3.On June 13, 2010, he received chemotherapy at Xiangya Hospital. 4.On June 18, 2010, Xiangya Hospital redid a pathological test on the myoma removed in 2007, and the result was found to have malignant changes. Wanted help: As a family member, we do not understand, we do not know medical knowledge, but we heard the doctor say that smooth muscle sarcoma is not sensitive to chemotherapy, and the best treatment is still surgery, so we want to consult the doctor. 1. If the lung is a metastatic lesion from the uterus, does the patient still have a chance for surgery? 2.The doctor said that to confirm the uterine lesion, either laparoscopy or removal of the tumor or together with the uterus, if this will aggravate the patient’s lung condition? 3.If the uterine tumor is confirmed to be benign after removal, will it have any effect on the lung condition? 4.If the uterine tumor is confirmed to be malignant after resection, can it be proved that the lung lesion is a distant metastasis from the uterus? 5.If the uterine tumor is not directly related to the lung tumor, is it possible to do lung surgery without dealing with the uterine tumor? 6.Is there any other effective treatment for smooth muscle sarcoma in China at present? I hope you will understand that I have asked so many questions and taken up so much of your time, but I feel sorry for myself, but I really have no choice. Thanks in advance! The PET-CT suggests that the SUV value of the lung nodule is significantly higher, which is a malignant lesion; the uterus has an area of increased SUV, which also suggests a malignant lesion; the surgical pathology suggests a smooth muscle sarcoma. We suggest active treatment, removal of the uterus, chemotherapy, and lung lesions after this depending on the situation. Patient: Thank you very much Dr. Ren for your busy reply! Your suggestions are good and we will take them on board. For now, we can only wait until after the second chemotherapy is finished (the second chemotherapy started on July 3) before we do the hysterectomy. If things are better after the hysterectomy, can we get you to do the lung surgery? You have seen the chest X-ray and there are lesions in both lungs, can the surgery be done? Is it worthwhile? Doctor: After the hysterectomy and chemotherapy and then review the chest CT, then decide the issue of chest surgery.