Brain and multiorgan metastases from uterine leiomyosarcoma

A 59-year-old woman, diagnosed 7 years ago with uterine leiomyosarcoma (ULMS), developed several intrathoracic, pelvic and lately intra-abdominal and brain metastases. On each occasion, surgical resection was followed by a course of failed chemotherapy. Lately she presented with acute neurological deterioration and focal signs. Magnetic resonance imaging demonstrated two presumed brain parenchymal lesions involving the supratentorial and infratentorial compartments. She underwent surgical resection of the left cerebellar lesion. Histological analysis of the brain specimen confirmed the presence of metastatic ULMS. Leiomyosarcoma of the uterus is an uncommon tumor with a very aggressive course and poor prognosis. Multiple organ metastases from ULMS are an extremely rare condition, and prognostically alarming despite current treatments.