Spinal manifestation of metastasizing leiomyosarcoma.
METHODS
Case report.


OBJECTIVE
To provide additional information on possible relations between uterine and spinal manifestations of leiomyosarcoma.


BACKGROUND
Spinal metastases and primary spinal manifestation of leiomyosarcoma and other malignant smooth muscle tumors are rarely observed.


METHODS
Clinical and radiologic follow-up of a patient with a spinal tumor.


RESULTS
A 46-year-old women had rapidly progressive paraplegia caused by an extramedullary lesion in the extradural space at T2-T3, with spinal cord compression. After surgical decompression, the resected tumor was histologically classified as a leiomyosarcoma. Diagnostic work-up failed to detect the primary tumor site. Previous medical history had been uneventful except for hysterectomy 3 years earlier for a leiomyoma. Extended necroses and focal metaplasia were already described in the hysterectomy specimen indicating malignant disease; however, it was not definitely diagnosed. Multiple leiomyosarcoma metastases developed 22 months later.


CONCLUSIONS
In retrospect, the origin of the leiomyosarcoma that manifested in the thoracic spine of the patient must be reconsidered. Rather than a primary dural leiomyosarcoma, this tumor represented the first evidence of recurrence of a missed diagnosis of early-stage uterine leiomyosarcoma.
Nanassis
K
K
Neurosurgical Clinic, Hippocrateion University Hospital, Thessaloniki, Greece.
Alexiadou-Rudolf
C
C
Tsitsopoulos
P
P
D014408:Biomarkers, Tumor / Q000032:analysis; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007890:Leiomyosarcoma / Q000737:chemistry / Q000556:secondary* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D013125:Spinal Neoplasms / Q000737:chemistry / Q000556:secondary* / Q000601:surgery; D013904:Thoracic Vertebrae / Q000473:pathology* / Q000601:surgery; D014594:Uterine Neoplasms / Q000473:pathology* / Q000601:surgery
D014408:Biomarkers, Tumor