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Brain and lung metastasis of uterine leiomyosarcoma: illustrative case
Hunter Richards1,2, Samir Alsalek1,2, Azim Laiwalla1,3
11Department of Neurosurgery, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California.
Background:
Uterine leiomyosarcoma is a rare, extremely aggressive tumor with a high rate of metastasis. Five-year survival for individuals with metastatic disease is only 10%-15%. Metastases to the brain are exceptionally rare and are associated with poor survival.
Observations:
The authors report a case of uterine leiomyosarcoma that metastasized to the brain in a 51-year-old woman. A single lesion on magnetic resonance imaging was discovered in the right posterior temporo-occipital region 44 months after resection of the primary uterine tumor. The patient underwent a right occipital craniotomy with gross-total resection of the tumor and is receiving adjuvant stereotactic radiosurgery and chemotherapy with gemcitabine and docetaxel. At 8 months postresection, the patient remains alive and asymptomatic with no sign of recurrence. A literature review of prior reported cases was conducted to analyze patterns of approach to patient treatment and survival.
Lessons:
The authors found an apparent survival benefit in patients receiving adjuvant radiation therapy.
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