Uterine leiomyosarcoma metastasizing to multiple sites: a rare presentation

Uma Handa, Reetu Kundu, Reeti Mehra, Romeeta Trehan, Harsh Mohan


Uterine leiomyosarcoma is a rare malignant neoplasm which has a dismal outcome especially when associated with widespread metastasis. It shows early metastasis primarily to the lungs, peritoneal cavity, bones, pelvic and para-aortic lymph nodes. We report simultaneous metastasis to the scalp, breast and soft tissue from leiomyosarcoma arising in the uterine broad ligament. Leiomyosarcoma poses a diagnostic difficulty at the metastatic site, especially when the primary site is unknown. Correct tumor typing and separating a primary from a metastatic one is important because of the different treatment modalities for both. Fine Needle Aspiration Cytology (FNAC) has emerged as an indispensable preliminary modality in investigating the metastatic disease and therefore cytomorphological recognition of the tumor presumes a great significance.


Uterine, Leiomyosarcoma, Metastasis, Cytomorphology, FNAC

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Yamada S, Yamada SM, Nakaguchi H, Murakami M, Hoya K, Matsuno A. A case of multiple brain metastases of uterine leiomyosarcoma with a literature review. Surg Oncol. 2011;20(4):e127-31.

Lusby K, Savannah KB, Demicco EG, Zhang Y, Ghadimi MPH, Young ED et al. Uterine leiomyosarcoma management, outcome, and associated molecular biomarkers: a single institution's experience. Ann Surg Oncol. 2013;20(7):2364-72.

Sibartie S, Larkin JO, Lee G, Fitzgibbon J, O'Reilly S, Richardson D. Metastatic uterine leiomyosarcoma presenting as a breast lump. Ir J Med Sci. 2011;180(4):889-91.

Pappa L, Zagorianakou N, Kitsiou E, Sintou-Mantela E, Bafa M, Malamnou-Mitsi V. Breast metastasis from uterine leiomyosarcoma diagnosed by fine needle aspiration: a case report. Acta Cytol. 2008;52(4):485-9.

Hsiao HH, Liu YC, Hou MF, Lin SF. Uterine leiomyosarcoma metastasis to the breast. Eur J Gynaecol Oncol. 2008;29(2):191-2.

Corcoran S, Hogan AM, Nemeth T, Bennani F, Sullivan FJ, Khan W et al. Isolated cutaneous metastasis of uterine leiomyosarcoma: case report and review of literature. Diagn Pathol. 2012;18(7):85.

Karabulut Z, Akkaya H, Moray G. Primary leiomyosarcoma of the breast: a case report. J Breast Cancer. 2012;15(1):124-7.

Shukla R, Pooja B, Radhika S, Nijhawan R, Rajwanshi A. Fine-needle aspiration cytology of extramammary neoplasms metastatic to the breast. Diagn Cytopathol. 2005;32(4):193-7.

Jun Wei X, Hiotis K, Garcia R, Hummel-Levine P. Leiomyosarcoma of the breast: a difficult diagnosis on fine-needle aspiration biopsy. Diagn Cytopathol. 2003;29(3):172-8.

Omeroglu G, Erssahin C, Potkul RK, Booth CN. FNA diagnosis of retroperitoneal leiomyosarcoma metastasizing to the breast. Diagn Cytopathol. 2007;35(8):508-11.

Rodríguez-Gil Y, Pérez-Barrios A, Alberti-Masgrau N, Garzón A, de Agustín P. Fine- needle aspiration cytology diagnosis of metastatic non haematological neoplasms of the breast: a series of seven cases. Diagn Cytopathol. 2012;40(4):297-304.

Gupta RK. Needle aspiration cytology and immunohistologic findings in a case of leiomyosarcoma of the breast. Diagn Cytopathol. 2007;35(4):254-6.