The paper describes a case of 10-year survival in a 52-year-old female patient after combination treatment (surgical tumor removal + chemotherapy + radiation therapy) for a size of 78´74´75-mm pelvic leiomyosarcoma. Single distant lung metastases have been selectively detected in the patient for 10 years. There was one metastasis at 4 years after treatment, one metastasis at 5 years, three metastases at 7 years, and one metastasis at 9 years. Atypical and wedge lung resections were performed using minimally invasive technologies, such as video-assisted thoracoscopic resection of the lung, which could maintain the function of external respiration at a satisfactory level. No local pelvic tumor recurrence was found. The patient leads an active lifestyle. After radical resection of primary leiomyosarcoma, surgical treatment for single metastases can prolong survival in patients.