Skull metastasis from uterine leiomyosarcoma: a case report

Abstract

Uterine leiomyosarcoma is a rare malignancy whose presenting symptoms usually are not specific for the disease. The clinical presentations include vaginal bleeding, pelvic pain or pressure, and awareness of an abdominal-pelvic mass. The diagnosis should be considered if rapid uterine enlargement occurs, especially in a post-menopausal woman. Local spreading of the tumor could involve the myometrium, pelvic blood vessels and lymphatics, contiguous pelvic structures, and then the abdominal organs, whereas distant metastasis most often involve the lungs. A 63-year-old female presented a rare uterine leiomyosarcoma metastasis to the skull with the manifestions of a bulging mass over her left occipito-parietal region. On admission, neurological examination revealed right hemiplegia. She underwent total resection of the tumor with the reconstruction of the dura, the skull plate and the scalp. Her post-operative course was smooth and the muscle power of her right limbs was improved from grade 1 to grade 3 after the procedure. The histological diagnosis is leiomyosarcoma. Aggressive management of the metastatic skull tumor is recommended in selected patients at least for a betterquality of life.