STUDY DESIGN: Case report. OBJECTIVE: To provide additional information on possible relations between uterine and spinal manifestations of leiomyosarcoma. SUMMARY OF BACKGROUND DATA: 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.
STUDY DESIGN: Case report. OBJECTIVE: To provide additional information on possible relations between uterine and spinal manifestations of leiomyosarcoma. SUMMARY OF BACKGROUND DATA: 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.
Authors: J M O'Brien; D D Brennan; D H Taylor; D P Holloway; B Hurson; J C O'Keane; S J Eustace Journal: Skeletal Radiol Date: 2004-05-04 Impact factor: 2.199