Koruga Nenad, Rončević Alen, Koruga Anamarija Soldo, Rajc Jasmina, Flam Josipa, Rotim Tatjana, Turk Tajana, Škiljić Sonja, Cesarik Marijan, Paun Tomislav
Department of Neurosurgery, University Hospital Center Osijek, Osijek, Croatia.
Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia.
Surg Neurol Int. 2024 Apr 12;15:128. doi: 10.25259/SNI_66_2024. eCollection 2024.
Leiomyosarcoma (LMS) is a rare malignancy that originates from smooth muscle. The most common sites of metastases include the lungs, liver, kidney, and skin. Notably, metastases of LMS to the central nervous system/or spine are extremely rare. When a cervical spinal LMS lesion was encountered, the patient successfully underwent gross total tumor resection with negative margins.
A 63-year-old female had undergone an anterior cervical C5-C7 diskectomy and fusion 18 years ago and resection of a retroperitoneal LMS 3 years ago. She newly presented with right-sided numbness and pain of 2 months duration that correlated with a focal right-sided C5-level hemiparesis (i.e., 4/5 motor strength). When the cervical magnetic resonance demonstrated a right-sided C5 intralaminar mass with extension into the C5-C6 foramen, she underwent posterior tumor resection; pathologically, this proved to be an LMS metastasis. Respectively, 1- and six months postoperatively, follow-up magnetic resonance imaging scans showed no tumor recurrence; she tolerated adjuvant oncological treatment accompanied by physical therapy. However, in one postoperative year, the lesion recurred, and she is presently under consideration for additional surgical management.
Gross total surgical resection is the first line of treatment for patients with metastatic LMS. Here, a patient with a C5 laminar/C5-C6 foraminal bony LMS metastasis underwent posterior tumor resection accompanied by adjuvant oncological treatment but exhibited disease recurrence within one postoperative year.
平滑肌肉瘤（LMS）是一种起源于平滑肌的罕见恶性肿瘤。最常见的转移部位包括肺、肝、肾和皮肤。值得注意的是，LMS转移至中枢神经系统/脊柱极为罕见。当遇到颈椎LMS病变时，患者成功接受了肿瘤全切术，切缘阴性。
一名63岁女性18年前接受了颈前路C5 - C7椎间盘切除术及融合术，3年前接受了腹膜后LMS切除术。她新出现了持续2个月的右侧麻木和疼痛，伴有右侧C5水平局灶性偏瘫（即肌力4/5）。当颈椎磁共振成像显示右侧C5椎板内肿块延伸至C5 - C6椎间孔时，她接受了后路肿瘤切除术；病理检查证实为LMS转移瘤。术后1个月和6个月的随访磁共振成像扫描显示无肿瘤复发；她耐受了辅助肿瘤治疗并接受了物理治疗。然而，术后1年病变复发，目前正在考虑进一步的手术治疗。
肿瘤全切术是转移性LMS患者的一线治疗方法。在此，一名患有C5椎板/C5 - C6椎间孔骨LMS转移瘤的患者接受了后路肿瘤切除术及辅助肿瘤治疗，但术后1年内疾病复发。
