Long survival with metastatic uterine leiomyosarcoma

A case of intramural uterine leiomyosarcoma is reported in which solitary asymptomatic subcutaneous metastases at two different sites appeared 3 and 4½ years, respectively, after hysterectomy without roentgenologic or clinical evidence of pulmonary metastases during this period. Three months after removal of the second subcutaneous metastasis, a large solitary pulmonary metastasis was removed by a right total pneumonectomy. Recurrent tumor in the chest wall near the thoracotomy incision was resected 3 months later, following which the patient was asymptomatic and apparently free of cancer until her sudden death 3 months after the last operation. In the absence of an autopsy, death at 68 was attributed to a cerebrovascular accident secondary to hypertensive cardiovascular disease.