Intracranial leiomyosarcoma: a neuro-oncological consequence of acquired immunodeficiency syndrome.

Leiomyosarcoma has recently been identified as an AIDS-related tumor, usually occurring in children in the chest or abdomen. We describe a case of intracranial leiomyosarcoma in an adult with AIDS. An enhancing mass adjacent to the right occipital cortical surface was diagnosed during a work-up for left arm weakness. Imaging characteristics were suggestive of a malignant neoplasm versus meningioma. The patient had a craniotomy for total excision of the lesion. Pathology showed a leiomyosarcoma. Metastatic work-up was negative. The patient refused radiation therapy, but is well without evidence of recurrence at 8 months follow-up. The differential diagnosis for intracranial lesions in AIDS should be expanded to include leiomyosarcoma. Surgical resection of the lesion is recommended.