Surgical management of primary leiomyosarcoma with intracranial and extracranial extension: a case report

Abstract

Background Primary intracranial-extracranial communicating leiomyosarcomas, which invade both intracranial and extracranial regions and involve complex anatomical structures, are extremely rare tumors. Case presentation: A 37-year-old male initially exhibited a subcutaneous mass on the left frontal vertex. Post-surgical resection, a recurrent mass manifested at the left frontotemporal vertex. Computed tomography (CT), and magnetic resonance imaging (MRI) revealed a lump on the left frontal vertex accompanied by an irregular abnormal lesion, and the diagnosis of leiomyosarcoma was confirmed. The patient underwent leiomyosarcoma excision under general anesthesia. The tumor recurred after 2 years and 4 months, leading to a more extensive surgical excision. Following a 2-year follow-up, the patient showed no major complications and maintained a stable condition. Conclusion Primary intracranial-extracranial communicating leiomyosarcoma is a rare condition. Surgical removal is the main therapeutic approach. The decision for lesion excision should consider factors such as the patient’s age, tumor location, pathological characteristics, and any distant metastasis.