A Case of Renal Metastasis of Uterine Leiomyosarcoma

Abstract

Renal metastasis from uterine leiomyosarcoma is extremely rare. We report a case of a middle-aged woman who presented with flank pain and was found to have a renal mass subsequently confirmed as metastatic leiomyosarcoma.

Case Report

A 52-year-old woman with a history of uterine leiomyosarcoma treated by hysterectomy two years earlier presented with dull left-sided flank pain. Physical examination was unremarkable. Contrast-enhanced CT of the abdomen revealed a well-defined, heterogeneous mass in the left kidney. No other metastatic lesions were identified.

CT-guided biopsy of the renal lesion showed spindle-cell morphology with marked atypia. Immunohistochemistry was positive for smooth muscle actin and desmin, consistent with metastatic leiomyosarcoma. The tumor was deemed resectable, and the patient underwent partial nephrectomy. Histopathology confirmed metastatic uterine leiomyosarcoma with clear margins.

The postoperative course was uneventful. She was referred for oncologic evaluation and started on adjuvant systemic therapy. At six-month follow-up, she remained asymptomatic with no radiologic evidence of recurrence.

Conclusion

Renal metastasis of uterine leiomyosarcoma is rare and may mimic primary renal tumors. A high index of suspicion and tissue diagnosis are essential for appropriate management.

Source: Bajic P, Gange W S, Blackwell R H, et al  A Case of Renal Metastasis of Uterine Leiomyosarcoma. Cureus 9(7):