A late systemic and brain metastasis from subcutaneous leiomyosarcoma of the right forearm: a case report and review of the literature.

Eric Dietel, Ulf Nestler, Hans Nenning, Christian Eisenlöffel, Ruth Stassart, Jürgen Meixensberger

Journal: Journal of medical case reports 2021;15(1):14

PMID: 33461603

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Abstract

BACKGROUND

Leiomyosarcomas are rare malignant tumors which originate from smooth muscle cells and very seldom give rise to intracerebral metastases. Nearly all cases of intracranial metastases stem from leiomyosarcomas of the uterus. We present a 61-year-old Caucasian man who developed multiple intracranial and extracranial metastases from leiomyosarcoma of the right forearm, diagnosed and treated 9 years before the current presentation.

CASE PRESENTATION

The Caucasian patient presented to the emergency department due to a progressive hemiparesis on the left side. Magnetic resonance imaging scans of the neurocranium showed multiple intracerebral masses with perifocal edema. One of these was located in the right parietal lobe, corresponding to the hemiparesis. The patient underwent microsurgical complete resection of the parietal mass and was subsequently subjected to further radiotherapy. Histopathological studies revealed metastasis of the former leiomyosarcoma.

CONCLUSIONS

Leiomyosarcomas represent a rare entity of mesenchymal tumors. Intracerebral metastasis of these tumors is even less frequent. This case shows the importance of long-term follow-up in patients with leiomyosarcoma.

Address: Department of Neurosurgery, University of Leipzig, Liebigstraße 20, 04103, Leipzig, Germany. [email protected].; Department of Neurosurgery, University of Leipzig, Liebigstraße 20, 04103, Leipzig, Germany.; Elsapark Pathology associates, Elsastraße 1, 04315, Leipzig, Germany.; Department of Neuropathology, University of Leipzig, Liebigstraße 26, 04103, Leipzig, Germany.

DOI: 10.1186/s13256-020-02625-0

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MeSH Terms: Brain Neoplasms, Cranial Irradiation, Forearm, Humans, Karnofsky Performance Status, Leiomyosarcoma, Magnetic Resonance Imaging, Male, Melena, Metastasectomy, Middle Aged, Neoplasm Recurrence, Local, Neurosurgical Procedures, Paresis, Pyloric Antrum, Radiotherapy, Sacrum, Soft Tissue Neoplasms, Spinal Neoplasms, Stomach Neoplasms, Subcutaneous Tissue, Time Factors