An intracerebral hematoma (ICH) developed in a patient during diagnostic evaluation for hemoptysis and guaiac-positive stools. Tissue obtained from colonic polyps, a pregastric mass, and cerebrum had features of poorly differentiated leiomyosarcoma. Only three other cases of pathologically confirmed cerebral metastasis of leiomyosarcoma are reported in the literature. The presence of cerebral metastasis at the time of the initial diagnosis of leiomyosarcoma and the associated ICH are features unique to this case.