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Objective: Primary intracranial leiomyomas are rare tumors. These tumors are mostly described in immunocompromised patients and associated with Epstein-Barr virus (EBV). The following report is an intracranial leiomyoma that was resected twice from a young, immunocompetent male. Methods: This is a report of a patient who initially presented with tremor and headaches. He was ultimately found to have a large 6 cm×8 cm tumor that was removed. Nine years later, he was found to have a small recurrence that was removed. No adjuvant therapies have been given. Results: His follow-up totals well over 11 years and he remains on observation. Extensive review of this rare entity is provided. Conclusion: It is suggested that observation without any adjuvant therapy be the treatment of choice after resection of primary intracranial leiomyomas. These uncommon, benign tumors should be followed long-term given their slow-growing nature.

Primary Intracranial Leiomyoma in Immunocompetent Patients: Case Report, Review of Literature and Treatment Recommendations