What are MRI findings of Spine Benign Metastasizing Leiomyoma? Case report with literature review

Junseok W. Hur, Sunhye Lee, Jang Bo Lee, Tai Hyoung Cho, Jung Yul Park

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Introduction: Benign Metastasizing Leiomyoma (BML) is a rare disease that results from metastasis of uterine leiomyoma to distant sites with benign pathologic features. Spine BML is very rare so the information of its features and pathophysiology is seldom known. Materials and Methods: We experienced a case of 42-year-old woman who presented with right buttock and leg pain with paresthesia. She had a surgical history of uterine myomectomy. Magnetic resonance imaging (MRI) of the lumbar spine revealed a well-circumscribed mass lesion in the posterior compartment of the L4 vertebral body, with extension into the ventral epidural space and both foramina. The mass showed hypointensity on T1-, T2-weighted images and strong homogeneous enhancement on gadolinium enhanced T1-weighted images. Tumor removal was conducted, and permanent biopsy revealed the mass as leiomyoma. Nine previous spine BML reports, which are known for all, were reviewed along with our case. We collated the clinical information and MRI findings of spine BML to figure out its common denominators. Results: Premenopausal women, previous history of uterine myoma, myomectomy/hysterectomy, and lung BML seemed to be predisposing clinical factors. For the imaging findings, posterior vertebral body invasion with bony destruction, neural foramen invasion, and canal encroachment were shown as common denominators. Especially in MRI findings, low T1 and T2 signal intensities with strong homogeneous enhancement were their common features. Conclusion: We gathered the fragmentary information of the spine BML for the first time, especially the MRI findings. Although spine BML is rare, it surely exists. Accordingly, spine surgeons should be suspicious of spine BML given its typical clinical history and MRI findings.

Original languageEnglish
Pages (from-to)600-605
Number of pages6
JournalEuropean Spine Journal
Volume24
DOIs
Publication statusPublished - 2015 May 1

Fingerprint

Leiomyoma
Spine
Magnetic Resonance Imaging
Uterine Myomectomy
Epidural Space
Myoma
Buttocks
Paresthesia
Gadolinium
Rare Diseases
Hysterectomy
Causality
Leg
Neoplasm Metastasis
Biopsy
Pain
Lung

Keywords

  • Batson plexus
  • Benign metastasizing leiomyoma
  • Metastatic spinal tumor
  • MRI
  • Spine

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

What are MRI findings of Spine Benign Metastasizing Leiomyoma? Case report with literature review. / Hur, Junseok W.; Lee, Sunhye; Lee, Jang Bo; Cho, Tai Hyoung; Park, Jung Yul.

In: European Spine Journal, Vol. 24, 01.05.2015, p. 600-605.

Research output: Contribution to journalArticle

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abstract = "Introduction: Benign Metastasizing Leiomyoma (BML) is a rare disease that results from metastasis of uterine leiomyoma to distant sites with benign pathologic features. Spine BML is very rare so the information of its features and pathophysiology is seldom known. Materials and Methods: We experienced a case of 42-year-old woman who presented with right buttock and leg pain with paresthesia. She had a surgical history of uterine myomectomy. Magnetic resonance imaging (MRI) of the lumbar spine revealed a well-circumscribed mass lesion in the posterior compartment of the L4 vertebral body, with extension into the ventral epidural space and both foramina. The mass showed hypointensity on T1-, T2-weighted images and strong homogeneous enhancement on gadolinium enhanced T1-weighted images. Tumor removal was conducted, and permanent biopsy revealed the mass as leiomyoma. Nine previous spine BML reports, which are known for all, were reviewed along with our case. We collated the clinical information and MRI findings of spine BML to figure out its common denominators. Results: Premenopausal women, previous history of uterine myoma, myomectomy/hysterectomy, and lung BML seemed to be predisposing clinical factors. For the imaging findings, posterior vertebral body invasion with bony destruction, neural foramen invasion, and canal encroachment were shown as common denominators. Especially in MRI findings, low T1 and T2 signal intensities with strong homogeneous enhancement were their common features. Conclusion: We gathered the fragmentary information of the spine BML for the first time, especially the MRI findings. Although spine BML is rare, it surely exists. Accordingly, spine surgeons should be suspicious of spine BML given its typical clinical history and MRI findings.",
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