Key Points
• Primary bone leiomyosarcoma is an exceedingly rare spindle cell tumor with smooth muscle differentiation.
• In all cases of leiomyosarcoma involving bone, metastatic disease must be excluded before being designated a primary bone leiomyosarcoma.
• Radiographs of primary bone leiomyosarcoma depict osteolytic lesions with aggressive features and ill-defined tumor margins.
• T2-weighted SE images of the tumor demonstrate areas of iso- and hypointensity relative to fat which may help distinguish primary bone leiomyosarcoma from other primary bone tumors.
• Primary bone leiomyoma and benign metastatic leiomyoma involving bone are exceptionally rare.
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Simpfendorfer, C., Sundaram, M. (2009). Smooth Muscle Tumors. In: Davies, A., Sundaram, M., James, S. (eds) Imaging of Bone Tumors and Tumor-Like Lesions. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-77984-1_21
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