Leiomyosarcoma (LMS) is a histological diagnosis. This means doctors diagnose the condition only based on the type of cells, namely smooth muscle cells, that are found in the biopsy (a sample of tissue is collected and examined under the microscope). It can affect any tissue or organ, which has smooth muscle lining. However, the most common ones include the abdominal organs, especially the uterus, followed by the blood vessels and the skin.
Leiomyosarcoma is a rare but aggressive type of cancer. It can grow fast and may even double in size in as little as four weeks. The treatment needs to be initiated as soon as possible after its diagnosis. Even after the treatment, there are high chances that this type of cancer will recur.
The signs and symptoms of leiomyosarcoma are nonspecific. They result from the compression of the adjacent tissue by the tumor. In the case of uterine leiomyosarcoma, the presenting symptom may be abnormal bleeding through the vagina and signs on imaging tests, such as ultrasonography. The sign may be extra growth on the uterus. This may be confused with a uterine fibroid (a noncancerous condition), so a biopsy is necessary. As the tumor grows, patients may experience other signs and symptoms, such as abdominal pain, nausea, fatigue and weight loss.
In patients diagnosed with LMS, prognosis depends on the following most important factors
- Histologic grade (based on examination of the tumor cells under the microscope)
- Tumor size
- Tumor depth
If the leiomyosarcoma has spread to the bones or the nerves, the chances of survival are less.
Uterine leiomyosarcoma is the most common form of leiomyosarcoma. It can start after 30 years of age. Most incidences are seen in women in the perimenopausal age group (fifth decade of life). About three out of every 10 women are diagnosed with leiomyosarcoma in the advanced stage of the disease.
The five-year survival rate of uterine leiomyosarcoma is 41 percent. This means 41 out of 100 women will survive for at least five years after the diagnosis.
How is leiomyosarcoma treated?
The best treatment for leiomyosarcoma depends on how big the tumor is and how far it has spread. Metastatic leiomyosarcoma (a tumor that has spread to distant tissues) is generally incurable. Treatments can help control the symptoms and improve survival and quality of life.
The treatment decision is based on the teamwork of oncosurgeons and oncologists. Oncosurgeons are doctors who are specialized in performing surgeries on cancerous organs. Oncologists are specialized doctors who are experts in the diagnosis and treatment of cancer. The primary treatment of leiomyosarcoma, regardless of the organ involved, is often surgery. The surgery involves excision of the tumor from the organ and any involved surrounding structures. In the case of uterine leiomyosarcoma, a total abdominal hysterectomy is usually recommended.
Radiation helps in local control of the tumor, preserves organ function and reduces local recurrence, but it does not improve survival.
If the leiomyosarcoma has spread (metastasized), medications that kill the cancerous cells are prescribed. This type of treatment is known as chemotherapy and it can be given in the form of injections or pills.
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