Cutaneous skull metastasis from uterine leiomyosarcoma: a case report

Barbetakis, Nikolaos; Paliouras, Dimitrios; Asteriou, Christos; Samanidis, George; Kleontas, Athanassios; Anestakis, Doxakis; Kaplanis, K; Tsilikas, Christodoulos

doi:10.1186/1477-7819-7-45

Cited by 28 publications

(29 citation statements)

References 14 publications

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“…Distant metastatic spread of ULMS has been described in lung [22], abdomen [23], soft tissue, and brain [24]. Less common metastatic sites include the breast [25] and bone [26]. Interestingly, another pathological entity, Benign Metastasizing Leiomyoma (BML) of the uterus describes metastasis of benign leiomyoma to the lung years post hysterectomy for uterine leiomyoma in pre-menopausal women.…”

Section: Discussionmentioning

confidence: 99%

Isolated cutaneous metastasis of uterine leiomyosarcoma: case report and review of literature

et al. 2012

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A 54 year old lady presented for routine excision of a scalp lesion thought clinically to represent a sebaceous cyst of the right occiput. 4 years earlier she underwent total abdominal hysterectomy and right salpingo-oophorectomy for 3 large uterine fibroids. Histo-pathological examination of the hysterectomy specimen revealed an incidental low-grade leiomyosarcoma. Staging imaging was negative for metastatic disease. She made an uneventful recovery and was treated further by adjuvant pelvic radiotherapy.She noticed an uncomfortable and unsightly cystic swelling on her occiput four years after hysterectomy and was referred for routine excision of what was believed to be a benign lesion. The lesion was excised and sent for histopathological examination. Microscopic analysis including immuno-histochemistry demonstrated an ER and PR positive metastatic deposit of leiomyosarcoma. The margins of excision were histologically clear of disease.At Multi-Disciplinary Team (MDT) discussion a diagnosis of metastatic scalp deposit from previous uterine leiomyosarcoma was made. Re-staging CT brain, thorax, abdomen and pelvis and MRI brain were negative for local recurrence or distant metastases. She is currently undergoing radiotherapy to the scalp and surrounding tissues and will be followed up closely by the involved teams.To the best of our knowledge, this is the first case described in the worldwide literature of isolated cutaneous metastasis to the scalp of uterine leiomyosarcoma without evidence of disseminated disease at other sites.Virtual slidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1311834987345566.

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Section: Discussionmentioning

confidence: 99%

Isolated cutaneous metastasis of uterine leiomyosarcoma: case report and review of literature

et al. 2012

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“…Lung, pancreatic, bone, and brain metastases have been described, and cases of thyroid, muscle, skull, head-and-neck, and breast metastasis have also been identified [4][5][6][7] . Uterine leiomyosarcomas can therefore behave in an unpredictable fashion, as demonstrated in this case of a 56-year-old patient whose cardiac metastasis manifested itself during adjuvant radiation treatment.…”

Section: Discussionmentioning

confidence: 99%

Right Atrial Metastasis of Uterine Leiomyosarcoma Causing Obstructive Shock

Nguyen

Wong

2012

Current Oncology

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Uterine leiomyosarcomas are rare tumours, and secondary cardiac metastases are even rarer. We present the case of a 56-year-old ethnic Chinese woman who was being treated with adjuvant pelvic radiation for uterine leiomyosarcoma when she presented with signs of right heart failure and shock. She was rapidly diagnosed with a solid mass attached to the tricuspid valve. Subsequent surgical resection revealed leiomyosarcoma metastasis. Metastases of uterine leiomyosarcoma to the heart are extremely rare, but clinicians should be aware of this phenomenon. Surgical resection, when feasible, can be associated with longer survival.

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“…Radiation therapy must be evaluated in relation to the place of recurrence and it is useful when local recurrence is difficult to treat surgically. Uterine LMS has a strong metastatic potential at distant sites, because of its aggressiveness and its propensity for hematogenous spread [17]. The most frequent sites of recurrence are the lungs, followed by the pelvis and liver [17].…”

Section: Discussionmentioning

confidence: 99%

“…Uterine LMS has a strong metastatic potential at distant sites, because of its aggressiveness and its propensity for hematogenous spread [17]. The most frequent sites of recurrence are the lungs, followed by the pelvis and liver [17]. Metastases are responsible for a worse prognosis with a median survival of <1 year.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Factors and Outcomes in 28 Cases of Uterine Leiomyosarcoma

et al. 2011

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Objectives: It was the aim of this study to evaluate clinicopathological characteristics and prognostic factors of uterine leiomyosarcomas (LMS). Methods: Twenty-eight patients with uterine LMS were evaluated in this retrospective study. Their features and survival were analyzed by Kaplan-Meier and log-rank tests. Results: The median age of the patients was 52 years (range 25–74). Nine patients had a disease with a mitotic count <10/10 high-power fields. Twenty-one patients presented with stage I disease, 1 with stage II and 6 with stage IV. Twelve patients underwent total hysterectomy and bilateral salpingo-oophorectomy, 2 simple hysterectomy, 5 myomectomy and 9 more comprehensive surgical treatments. Adjuvant chemotherapy was administered to 16 patients, whereas chemoradiation was given only to 2 patients. Fifty percent presented with recurrence of the disease. The median overall survival was 46 months. Age, mitotic count, type of surgery, adjuvant therapy, recurrence and clinical response to chemotherapy were not found to affect survival, while the menopausal status and FIGO (International Federation of Gynecology and Obstetrics) stage were found to be prognostic factors. Conclusion: In our series, the menopausal state and FIGO stage were found to be prognostic factors related to survival.

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Cutaneous skull metastasis from uterine leiomyosarcoma: a case report

Abstract: Background: Cutaneous metastases in the facial region occur in less than 0.5% of patients with metastatic cancer.

Cited by 28 publications

References 14 publications

Isolated cutaneous metastasis of uterine leiomyosarcoma: case report and review of literature

Isolated cutaneous metastasis of uterine leiomyosarcoma: case report and review of literature

Right Atrial Metastasis of Uterine Leiomyosarcoma Causing Obstructive Shock

Prognostic Factors and Outcomes in 28 Cases of Uterine Leiomyosarcoma

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