Treatment of skull metastasis from uterine leiomyosarcoma: A single-center experience with literature review

Abstract Aim Intracranial metastases from uterine leiomyosarcoma, particularly solitary skull metastases, are very rare, with only five cases reported to date. In this study, we present our experience with the treatment of these lesions, along with a review of the previously reported cases. To the best of our knowledge, this represents the first review of cases of skull metastasis from uterine leiomyosarcoma. Material and Methods We examined three patients with skull metastases from uterine leiomyosarcomas. Planning their treatment was challenging because of the lack of literature on such cases. Results Gross tumor resection with a 1-cm surgical margin was performed in all three cases. One of the patients also received postoperative radiation therapy. In two cases, there was no recurrence until the 15-month follow-up. The third patient developed two recurrences within a short period, and after two operations, she was treated with nivolumab. Genomic analysis was also performed in one case. Conclusions Due to the lack of effective chemotherapy, skull metastasis from uterine leiomyosarcoma has a poor prognosis. However, in cases where genomic analysis does not indicate a poor prognosis, surgical treatment may be effective and is recommended.