Primary Osseous Leiomyosarcoma of the Spine: A Rare Entity—Case Report and Review of the Literature

Abstract

Primary osseous leiomyosarcoma of the spine is an extremely rare entity with only 13 previous cases having been reported in the literature. We present the case of a 57-year-old woman with a tumor of the eleventh thoracic vertebra, causing compression of the spinal cord. Histopathology and immunohistochemical results of the tumor biopsy specimen disclosed a primary leiomyosarcoma of the thoracic spine. We report on the features of this rare entity but also review and summarize the imaging and pathology characteristics that can be extrapolated from the existing literature.

MR Imaging Findings of a Leiomyosarcoma of the Thoracic Spine: A Case Report

“…Leiomyosarcoma frequently occurs in the uterus, retroperitoneal space, gastrointestinal tract, and deep soft tissues, and primary leiomyosarcoma of the bone is rare [2][3][4][5]. It is speculated that the very rare tumor, primary leiomyosarcoma of bone, arises from pre-existing smooth muscle cells in the media of intraosseous blood vessels [4].…”

“…There are several imaging findings of spinal leiomyosarcoma in the literature [4][5][6][7][8]. According to these reports, CT usually shows an ill-defined lytic mass.…”

“…Leiomyosarcoma often occurs in the uterus and deep soft tissues, especially of the retroperitoneal space, subcutaneous tissues, gastrointestinal tract, and medium-to large-sized veins [2][3][4][5]. Primary osseous leiomyosarcoma of the spine is an extremely rare occurrence; to our knowledge, only 14 cases have been reported in the literature [4][5][6][7][8]. However, imaging findings for these tumors are nonspecific, leading to difficulties with making a radiological diagnosis.…”

Synchronous Primary Leiomyosarcoma in the Thoracic Vertebra and the Liver

“…On the other hand, primary leiomyosarcoma of bone is quite rare. 3 Mirra 4 reported an incidence pathologically confirmed primary bone tumors of less than 0.1%. Leiomyosarcoma commonly affects the metaphyseal portion of the long tubular bones, particularly bones near the knee joint.…”

“…2 Primary leiomyosarcomas of the vertebrae are extremely rare; only 14 cases have been reported in the literature to date. 3 To accurately diagnose a primary vertebral leiomyosarcoma, a metastasis from other primary sites needs to be ruled out through a systemic evaluation.…”