The case is a 56-year-old woman who presented with cord compression from a lesion of the thoracic spine. Histologic analysis confirmed the diagnosis of a spindle cell sarcoma. Ultrastructural analysis showed features characteristic of a leiomyosarcoma. Subsequent discussion with the patient revealed a history of hysterectomy performed for fibroid uterus 5 years before the current presentation. Review of the previous surgical specimen confirmed the presence of a leiomyosarcoma originally interpreted as a large infarcted myoma.