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Year : 2015  |  Volume : 2  |  Issue : 1  |  Page : 24-26

Intraosseous leiomyoma in the sacrum

1 Colonel, Department of Neurosurgery, Base Hospital, Delhi Cantonment, New Delhi, India
2 Department of Radiodiagnosis, INHS Asvini, Mumbai, Maharashtra, India
3 Department of Pathology, Armed Forces Medical College, Pune, Maharashtra, India

Correspondence Address:
S K Sengupta
Colonel, Department of Neurosurgery, Base Hospital, Delhi Cantonment, New Delhi
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Source of Support: None, Conflict of Interest: None

DOI: 10.5005/jp-journals-10039-1050

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Background: Leiomyomas originate from smooth muscle, with uterus being the most common site of origin. Intraosseous leiomyomas are very rare. Few cases of primary intraosseous leiomyomas have been reported in the mandible, appendicular skeleton and rib. To the best of our knowledge, there is no previous report of a primary intraosseous leiomyoma in the sacrum. Purpose: To report the clinical presentation, magnetic resonance imaging (MRI) findings, peroperative findings and histopathology of a case of a sacral intraosseous leiomyoma. Study design: Observational case report. Materials and methods: A 26 years old male presented with acute onset low backache, without any neurological deficit. magnetic resonance imaging LS Spine revealed an intraosseous mass in the sacrum, which was excised. Histopathological examinations proved the mass to be a leiomyoma. Patient became asymptomatic postoperatively. On follow-up, 2 years after surgery, patient is asymptomatic and neuroimaging revealed no recurrence. Result: Peroperatively, a lobulated, yellowish, sharply demarcated, soft to firm, expansile mass was encountered between the inner and the outer table of the lamina of the S1 vertebra, which was detected to have bundles of spindle shaped cells with oval nuclei arranged in a fibrous stroma on H and E stain. On immunohistochemistry (IHC), it showed positivity for smooth muscle actin (SMA) and vimentin and was negative for cytokeratin (CK), epithelial membrane antigen (EMA), neuron-specific enolase and desmin. Conclusion: To the best of our knowledge, this is the first case report, in English literature, of a primary intraosseous leiomyoma in the sacrum.

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