What Is Leiomyosarcoma?
Leiomyosarcoma (LMS) is a rare type of soft tissue cancer that grows in the smooth or involuntary muscles. Leiomyosarcoma typically affects the uterus but can also affect other areas of the body such as the bladder or gastrointestinal system.
Leiomyosarcoma frequently recurs after treatment when it is not diagnosed early.
What Are Symptoms of Leiomyosarcoma?
Symptoms of leiomyosarcoma vary depending on the location, size, and spread (metastases) of the tumor.
Early on, leiomyosarcoma may not cause symptoms. General symptoms associated with cancer may occur such as:
When symptoms of leiomyosarcoma occur, they may include:
- A detectable mass/lump under the skin or on the body
- Unusual swelling anywhere in the body
- Bloating and abdominal swelling
- Pain in the affected area (uncommon)
- Trouble breathing
- A leiomyosarcoma in the gastrointestinal tract may cause bleeding in the gastrointestinal tract that may result in black, tarry, foul-smelling stools, vomiting blood, or abdominal discomfort
- A leiomyosarcoma of the uterus may cause abnormal bleeding from the uterus and the vagina, with abnormal vaginal discharge, and a change in bladder or bowel habits
What Causes Leiomyosarcoma?
The cause of leiomyosarcoma is unknown. It is believed certain genetic conditions may contribute to the development of LMS, such as:
- Hereditary retinoblastoma
- Li-Fraumeni syndrome
- Neurofibromatosis type 1
- Tuberous sclerosis
- Nevoid basal cell carcinoma syndrome
- Gardner syndrome
- Werner syndrome
Risk factors for leiomyosarcoma include:
- Age: occurs most often over the age of 50
- Exposure to radiotherapy treatment for other forms of cancer
- Chemical exposure (especially vinyl chloride, dioxins, and herbicides)
- Use of immunosuppressive drugs
- Human immunodeficiency virus (HIV)
- Human herpes virus type 8
- Edematous arms after radical mastectomy
Some causes of sarcomas are believed to also be potential causes for LMS, such as:
- Autoimmune diseases
- Thyroid disorders
- Hormonal issues relating to estrogen
- Exposure to cyclophosphamide
- People in post-transplant immunosuppression stages
- People whose bodies are in a state of chronic repair (such as those with ulcers, inflammation, etc.)
Another factor that may play a role in the spread of leiomyosarcoma is use of a surgical device called a power morcellator, used for gynecological surgical procedures to remove tumors and diseased tissue or organs through minimally invasive surgery. Power morcellators may leave cells of shredded tissue behind which can spread cancer cells when tumors are removed.
In patients who may have an early stage, new leiomyosarcomas which are malignant will spread with use of power morcellation. Leiomyosarcoma that has been spread through power morcellation can affect any organ in the abdominal cavity including the liver, kidneys, bladder, intestines or abdominal wall. Cancer cells shed due to morcellation can also potentially enter the blood or lymphatic system and travel to other parts of the body such as the bones, lungs, heart or brain. This makes treatment much more difficult and can lead to a poorer prognosis.
How Is Leiomyosarcoma Diagnosed?
In addition to a patient history and physical examination, tests used to diagnose leiomyosarcoma include:
What Is the Treatment for Leiomyosarcoma?
Treatment for leiomyosarcoma depends on the size and location of the tumor and may include one or more of the following:
- This is the best treatment option
- Surgical excision and removal of the entire tumor and surrounding tissue (resection)
- May include reconstructive surgery depending on the location
- If all of the tumor is removed, there is a good chance for a cure
- If some cancer cells are left behind, there is a chance the cancer will recur
- Radiation therapy
- May be used around the time of surgery
- Radiation is aimed at the tumor area to prevent it from growing back after removal
- Used in combination with surgery for larger tumors, or when cancer cells have spread to other parts of the body
Chemotherapy and radiation therapy are not always effective in slowing or stopping progression of leiomyosarcomas. Leiomyosarcomas are very rare, so no standard effective type of chemotherapy or radiation therapy has been identified.
What Is the Life Expectancy for Leiomyosarcoma?
Leiomyosarcoma is a very aggressive cancer that is often not responsive to treatments. Life expectancy is higher for patients who are diagnosed early, treated effectively with surgical removal of a local tumor and adjuvant therapies, and who follow up with regular checkups.
High-grade tumors and those that have spread (metastasized) to other parts of the body tend to have less favorable survival rates.
Life expectancy for leiomyosarcoma is often expressed in 5-year survival rates, that is, how many people will be alive 5 years after diagnosis.
Leiomyosarcoma 5-year survival rates:
- Localized (no sign the cancer has spread outside the original site): 63%
- Regional (cancer has spread some, but has not progressed farther than the region where it first originated): 36%
- Distant (cancer has spread to distant parts of the body): 14%
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