Metastatic leiomyosarcoma of the thoracic spine: case report

Abstract

Leiomyosarcoma is a rare malignant mesenchymal tumor arising from smooth muscle cells. Metastatic spreading is possible, which even rarely metastasize to the bone being the latter localization a delayed manifestation of its natural progression. Spinal metastases represent the most common bone localizations with prevalence in the thoracic and lumbar spine. We present a 55-year-old female, operated there’s 2 years for a hysterectomy of uterine leiomyosarcoma, admitted in our department with a flaccid paraplegia. Spine magnetic resonance imaging showed an extradural mass, iso-intense on T2, enhancing after gadolinium administration; placed at T5-T6 level with a severe cord compression. The patient underwent a decompressive laminectomy T5 and a total removal of the tumor. The histological examination revealed a metastatic leiomyosarcoma. The prognosis of patients with leiomyosarcoma is variable depending on the resectability and existence of metastasis. The essential treatment is surgery but an additional therapy, such as radiotherapy and/or chemotherapy, may be required to improve local control.