Abstract
The metastases of uterine leiomyosarcoma to the brain are exceptional and such cases are seldomly reported in the literature. The diagnosis is based on CT and brains MRI findings, in association with a gynecological history of cancer. Their management still stays without guidelines, and the surgical total resection is known to be the only way to influence positively the prognosis and save patient lives. We report a rare case of a 46 years old woman who underwent a hysterectomy and bilateral salpingo-oophorectomy 5 years earlier and presented with the right hemiparesis and whose CT scan and MRI of the brain showed cerebral lesions related to brain location of uterine leiomyosarcoma. The patient underwent surgery for gross total tumor resection, followed by adjuvant radiotherapy, and was doing well after surgery. Three months later she was admitted for recurrences and died after two months of palliative care.
Highlights
Brain metastases frequently occur secondary to poorly controlled primary lung, breast, melanoma, colorectal and renal tumors [1]
We report a rare case of a 46 years old woman who underwent a hysterectomy and bilateral salpingo-oophorectomy 5 years earlier and presented with the right hemiparesis and whose CT scan and MRI of the brain showed cerebral lesions related to brain location of uterine leiomyosarcoma
In contrast to endometrial carcinomas which most commonly metastasize to the lymph nodes, Uterine leiomyosarcoma (ULMS) has a high propensity for hematogenous spread most commonly to the lungs [3]
Summary
Brain metastases frequently occur secondary to poorly controlled primary lung, breast, melanoma, colorectal and renal tumors [1]. These tumors are the most common sources of brain metastases in adults. Uterine leiomyosarcoma (ULMS) is a rare entity among malignant gynecologic tumors with a very poor prognosis. We report a very rare case of a 46 years old woman with a gynecologic history of uterine leiomyosarcoma operated and treated by adjuvant radiotherapy five years earlier, presented with agressive brain tumor with extension to the lungs and who underwent surgery, followed by adjuvant radiotherapy for metastases of this tumor to the brain with a good immediate outcome, and died a few months later because of the brain tumor recurrences
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