Leiomyosarcoma metastatic to the cervical spine causing a C6 compression fracture: A case report

Abstract

Leiomyosarcoma is a rare malignant tumor derived from smooth muscle cells, which commonly metastasizes to the lungs, liver, kidney, brain and skin. The current study presents the case of a 42-year-old male who presented with progressive neck pain and numbness of the left arm. Spinal computed tomography and magnetic resonance imaging revealed osteolytic lesions of numerous vertebrae (C2, C3, C4, C5, C6, C7, T1 and T2). With regard to the C6 vertebra, total destruction of the vertebral body resulted in vertebral collapse and subsequent spinal cord compression. The patient underwent an anterior C6 corpectomy, reconstruction with a mesh cage filled with polymethyl methacrylate (PMMA) and open PMMA infusion to C5 and C7. The surgical procedure significantly alleviated the symptoms and obtained a reliable reconstruction. The clinical follow-up examination at 13 months was uneventful with the exception of mild numbness of the left hand since the surgery. To the best of our knowledge, this is the first case of leiomyosarcoma recurrence presenting in the cervical spine, and the present study provides insight into the use of a surgical technique that has rarely been used in the cervical spine.

A rare presentation of leiomyosarcoma metastasis to the cervical spine: A case report and a brief review

“…Sun et al, in 2013, reported a metastatic LMS lesion to the cervical spine with destruction of the C6 vertebra; the patient underwent an anterior decompression and fusion. [8] In 2022, LiBrizzi et al retrospectively analyzed bone metastases in LMS patients; most involved the femur, humerus, and spine; the latter were typically managed with kyphoplasty, decompression alone, and/or decompression and fusion. [4] Survival rates for spinal LMS LMS are aggressive, highly malignant lesions that frequently recur and metastasize.…”

“…[ 2 ] Metastatic LMS spinal lesions classically have a poor prognosis due to the high risk for tumor recurrence and relative resistance to radiation and/or chemotherapy. [ 8 ] Here, a 63-year-old female who, in 2021, had a retroperitoneal LMS resected newly presented with a right C5 level hemiparesis attributed to a C5 laminar/C5–C6 bony foraminal lesion. Following resection, the lesion proved to be a LMS metastasis that recurred within one year following gross total tumor removal despite adjuvant oncologic treatment.…”