Clinical Neuroradiology

, Volume 26, Issue 2, pp 229–233 | Cite as

MR Imaging Findings of a Leiomyosarcoma of the Thoracic Spine: A Case Report

  • K. Tahara
  • K. YamashitaEmail author
  • A. Hiwatashi
  • O. Togao
  • K. Kikuchi
  • M. Endo
  • H. Otsuka
  • Y. Oda
  • H. Honda


We report a case of leiomyosarcoma of the thoracic spine. Primary leiomyosarcoma is a malignant connective tissue tumor originating from smooth muscle cells. Leiomyosarcoma frequently occurs in the uterus, retroperitoneal space, gastrointestinal tract, and deep soft tissues; primary leiomyosarcoma of the bone is rare. The MR imaging including intravoxel incoherent motion (IVIM) imaging findings of the current case indicated a low diffusion coefficient and high blood flow, which were in concurrence with high cell density on histology and increased vascularity by angiography. Although some benign tumors such as osteoblastoma and giant cell tumor would show similar findings on IVIM imaging, these additional imaging features may narrow the differential diagnosis of spinal tumors.


Leiomyosarcoma Spine MR IVIM 



This work was supported by JSPS KAKENHI Grant Number 26461828.

Conflict of Interest

The authors have no conflict of interest to declare. Publication is approved by all authors and explicitly by the responsible authorities where the work was carried out.


  1. 1.
    Russell WO, Cohen J, Enzinger F, Hajdu SI, Heise H, Martin RG, Meissner W, Miller WT, Schmitz RL, Suit HD. A clinical and pathological staging system for soft tissue sarcomas. Cancer. 1977;40(4):1562–70.CrossRefPubMedGoogle Scholar
  2. 2.
    Evans DM, Sanerkin NG. Primary leiomyosarcoma of bone.J Pathol Bacteriol. 1965;90(1):348–50.CrossRefPubMedGoogle Scholar
  3. 3.
    Berlin O, Angervall L, Kindblom LG, Berlin IC, Stener B. Primary leiomyosarcoma of bone. A clinical, radiographic, pathologic-anatomic, and prognostic study of 16 cases. Skeletal Radiol. 1987;16(5):364–76.CrossRefPubMedGoogle Scholar
  4. 4.
    Lo TH, van Rooij WJ, Teepen JL, Verhagen IT. Primary leiomyosarcoma of the spine. Neuroradiology. 1995;37(6):465–7.CrossRefPubMedGoogle Scholar
  5. 5.
    Potsi M, Stavrinou P, Patsinakidis N, Hatzibougias D, Foroglou N, Karayanopoulou G, Kalogera-Founzila A. Primary osseous leiomyosarcoma of the spine: a rare entity–case report and review of the literature. J Neurol Surg A Cent Eur Neurosurg. 2012;73(4):238–42. doi:10.1055/s-0032-1313588.CrossRefPubMedGoogle Scholar
  6. 6.
    Ochiai H, Yamakawa Y, Fukushima T, Yamada H, Hayashi T. Primary leiomyosarcoma of the cervical spine causing spontaneous compression fracture: report of an autopsy case. Neuropathology. 2000;20(1):60–4.CrossRefPubMedGoogle Scholar
  7. 7.
    Sasaguri T, Tanimoto A, Kimura S, Kohno Y, Hirasawa M, Matsuki Y, Abe K, Hashimoto H, Hamada T, Sasaguri Y. Primary leiomyosarcoma of the vertebra: case report and review of the literature. Pathol Int. 2004;54(1):73–6.CrossRefPubMedGoogle Scholar
  8. 8.
    Dohi O, Hatori M, Ohtani H, Watanabe M, Kokubun S. Leiomyosarcoma of the sacral bone in a patient with a past history of resection of uterine leiomyoma. Ups J Med Sci. 2003;108(3):213–20.CrossRefPubMedGoogle Scholar
  9. 9.
    Elhammady MS, Manzano GR, Lebwohl N, Levi AD. Leiomyosarcoma metastases to the spine. Case series and review of the literature. J Neurosurg Spine. 2007;6(2):178–83.CrossRefPubMedGoogle Scholar
  10. 10.
    Kadry M, Sievers C, Engelmann C. Pulmonary leiomyomatosis in women after hysterectomy for uterine myoma. Benign metastasizing leiomyoma? Acta Chir Hung. 1999;38(1):57–61.PubMedGoogle Scholar
  11. 11.
    Bihan D L, Breton E, Lallemand D, Aubin ML, Vignaud J, Laval-Jeantet M. Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging. Radiology. 1988;168(2):497–505.CrossRefPubMedGoogle Scholar
  12. 12.
    Federau C, Meuli R, O’Brien K, Maeder P, Hagmann P. Perfusion measurement in brain gliomas with intravoxel incoherent motion MRI. AJNR Am J Neuroradiol. 2014;35(2):256–62.CrossRefPubMedGoogle Scholar
  13. 13.
    Sumi M, Van Cauteren M, Sumi T, Obara M, Ichikawa Y, Nakamura T. Salivary gland tumors: use of intravoxel incoherent motion MR imaging for assessment of diffusion and perfusion for the differentiation of benign from malignant tumors. Radiology. 2012;263(3):770–7.CrossRefPubMedGoogle Scholar
  14. 14.
    Sato K, Yuasa N, Fujita M, Fukushima Y. Clinical application of diffusion-weighted imaging for preoperative differentiation between uterine leiomyoma and leiomyosarcoma. Am J Obstet Gynecol. 2014;210(4):368 e1–8.CrossRefPubMedGoogle Scholar
  15. 15.
    Tamai K, Koyama T, Saga T, Morisawa N, Fujimoto K, Mikami Y, Togashi K. The utility of diffusion-weighted MR imaging for differentiating uterine sarcomas from benign leiomyomas. Eur Radiol. 2008;18(4):723–30.CrossRefPubMedGoogle Scholar
  16. 16.
    Punt SE, Eary JF, O’Sullivan J, Conrad EU. Fluorodeoxyglucose positron emission tomography in leiomyosarcoma: imaging characteristics. Nucl Med Commun. 2009;30(7):546–9.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Aoki J, Watanabe H, Shinozaki T, Takagishi K, Ishijima H, Oya N, Sato N, Inoue T, Endo K. FDG PET of primary benign and malignant bone tumors: standardized uptake value in 52 lesions. Radiology. 2001;219(3):774–7.CrossRefPubMedGoogle Scholar
  18. 18.
    Choi YY, Kim JY, Yang SO. PET/CT in benign and malignant musculoskeletal tumors and tumor-like conditions. Semin Musculoskelet Radiol. 2014;18(2):133–48.CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • K. Tahara
    • 1
  • K. Yamashita
    • 1
    Email author
  • A. Hiwatashi
    • 1
  • O. Togao
    • 1
  • K. Kikuchi
    • 1
  • M. Endo
    • 2
  • H. Otsuka
    • 3
  • Y. Oda
    • 3
  • H. Honda
    • 1
  1. 1.Department of Clinical Radiology, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
  2. 2.Department of Orthopaedic Surgery, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
  3. 3.Department of Anatomic Pathology, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan

Personalised recommendations