Benign metastasizing leiomyoma to skull base and spine: a report of two cases

Objective and importance: We report two patients with benign uterine leiomyoma metastasizing to the nervous system, respectively, to the skull base and to the spine. Although primary cranial and metastatic spinal leiomyomas have been rarely described, to our knowledge no case of benign leiomyoma metastasizing to the skull base has been reported before. Clinical presentation: Two female patients with history of hysterectomy for benign leiomyoma, subsequently metastasizing to the lungs and smooth muscles of the skin, presented with a focal neurologic deficit. Magnetic resonance imaging revealed a sacral mass in one case and a skull base tumor in the other. Intervention: Both patients underwent surgery for resection of the lesions. Good postoperative results were obtained. Histologic examination of the surgical specimen revealed a benign metastasizing leiomyoma. Conclusion: Benign metastasizing leiomyoma should be considered in the differential diagnosis of mass lesions in the sacral spine and skull base in patients who have a history of uterine leiomyoma or benign metastases of the same disease in organs outside the nervous system.