Paraparesis due to spinal leiomyosarcoma lesion in the thoracic spine accompanied by two leiomyosarcoma lesions in the back and the thigh over an interval of 4 years

Ido, Kazuhiro; Matsuoka, Hidenori; Yoshida, Masumi; Urushidani, H.

doi:10.1054/jocn.2001.0989

Cited by 14 publications

(10 citation statements)

References 9 publications

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“…7,9,19 It is extremely uncommon, however, for a spinal metastatic lesion to be the presenting symptom of leiomyosarcoma, as was seen in Cases 1 to 4 (Table 1). Osseous metastasis is rare, the spine being one of the more common sites of osseous involvement.…”

Section: Discussionmentioning

confidence: 97%

“…Review of the uterine pathological features confirmed the initial diagnosis of a benign tumor; however, histopathological diagnostic errors in benign uterine leiomyomatous disease are common because of the bulky nature of these tumors and subsequent limitations in sampling. 4,9,11,12,19,20 With the addition of Case 4, a total of five cases (Table 1) ages ranging from 42 to 83 years (mean age 53.8 years). A review of the literature demonstrates that no histological criteria have proven reliable in predicting whether these lesions are benign or malignant.…”

Section: Discussionmentioning

confidence: 99%

“…Histopathologically, distinguishing leiomyosarcoma from other aggressive spindle cell tumors is not always straightforward, 1,9,17,19 especially in cases in which no other primary lesion can be found or in cases in which there is a history of hysterectomy for a benign myoma or in patients in whom the initial uterine lesion cannot be pathologically reviewed. In such cases leiomyosarcoma must be differentiated from other spindle cell neoplasms including metastatic spindle cell carcinoma, primary fibrosarcoma, malignant fibrous histiocytoma, and fibrosarcomatous portion of osteosarcoma.…”

Section: Discussionmentioning

confidence: 99%

“…2 A cartwheel pattern has also been reported. 1,2,9,13,19 Leiomyosarcoma cells are positive for vimentin, HHF35 (common muscle actin), and ␣-smooth-mus-cle actin. 1,2,9,13,19 Leiomyosarcoma cells are positive for vimentin, HHF35 (common muscle actin), and ␣-smooth-mus-cle actin.…”

Section: Discussionmentioning

confidence: 99%

“…4,6,12 Distant metastatic lesions generally represent a late manifestation of the disease and most commonly occur in the lungs, liver, kidney, brain, and skin. 7,9,19 It is extremely uncommon, however, for an osseous metastatic lesion to be the presenting manifestation of leiomyosarcoma. 7,9,19 It is extremely uncommon, however, for an osseous metastatic lesion to be the presenting manifestation of leiomyosarcoma.…”

mentioning

confidence: 99%

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Leiomyosarcoma metastases to the spine

Elhammady

Manzano²,

Lebwohl

et al. 2007

SPI

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✓Leiomyosarcoma is a rare malignant smooth-muscle tumor that rarely metastasizes to bone. It is extremely uncommon for osseous metastasis to be the initial presentation of leiomyosarcoma or to be the initial manifestation of recurrence in patients with a history of leiomyosarcoma. The authors have treated four cases of metastatic leiomyosarcoma with the lesion initially presenting in the spine, and a fifth case of disseminated leiomyosarcoma that involved the spine. In their report, they highlight the cases of two of these patients and provide tabular data for the remaining three. The authors performed a comprehensive review of the literature on spinal leiomyosarcomas and retrospective chart reviews of five surgically treated patients in whom a spinal metastatic leiomyosarcoma was diagnosed. Their series consists of five women who ranged in age from 36 to 47 years (mean age 43.2 years). Four patients had known, or presumed, uterine primary lesions, whereas one harbored a retroperitoneal primary tumor. These lesions generally appear as lytic foci on imaging studies, but variable imaging characteristics were observed. All cases were managed aggressively: four patients underwent posterior/posterolateral decompression and fusion, and one underwent anterior–posterior en bloc resection and fusion. In all cases preoperative symptoms resolved. Two patients died 9 and 13 years after initial presentation. The remaining patients are alive and neurologically intact. Metastatic spinal leiomyosarcomas tend to symptomatically involve only one spinal level at the time of diagnosis and are known to recur locally. These lesions commonly affect women in early middle age, and long-term survival, even in those with systemic metastatic lesions, is better than that seen in individuals with more aggressive spinal metastases. Attempted gross-total resection with fusion, as opposed to minimal palliative decompression, is recommended.

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Section: Discussionmentioning

confidence: 97%