Treatment of recurrent metastatic uterine leiomyosarcoma of the spine: a multimodality approach using resection, radiosurgery, and chemotherapy

J Neurosurg Spine. 2015 Nov;23(5):607-612. doi: 10.3171/2015.1.SPINE14640. Epub 2015 Jul 17.

Abstract

The authors describe the case of a patient who initially presented with uterine leiomyosarcoma (LMS) that later metastasized to the spine. The patient was treated at another institution for her primary uterine LMS, undergoing resection followed by adjuvant chemotherapy. After several years of disease remission, the patient presented in January 2011 to the authors' institution with recurrent uterine LMS metastatic to the spine, which has been treated with multiple therapeutic modalities in a combination of surgery, radiosurgery, and chemotherapy. As a result of this approach, the patient has been progression free for 35 months since her presentation (April 2011 to March 2014). We herein describe our experience treating this patient with recurrent uterine LMS of the spine and suggest that patients with recurrent uterine LMSs should be considered for treatment using a multimodality approach with emphasis on enrollment into clinical trials.

Keywords: 4-demethyl-4-cholesteryloxycarbonylpenclomedine; DM-CHOC-PEN; DM-CHOC-PEN: 4-demethyl-4-cholesteryloxycarbonylpenclomedine; LMS = leiomyosarcoma; TAHBSO = total abdominal hysterectomy and bilateral salphingo-oophorectomy; TMZ = temozolomide; chemotherapy; multimodality treatment; oncology; radiosurgery; recurrence; spinal metastasis; uterine leiomyosarcoma.