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Origin and Causes

Leiomyosarcoma is an aggressive soft tissue cancer that develops in smooth muscle tissue found in the uterus, gastrointestinal tract, and other soft tissues. Leiomyosarcomas make up about 15% of soft tissue sarcomas. Women are more at risk than men (2:1 ratio), especially in their 5th-6th decade of life. No specific cause has been determined to explain the occurrence of this sarcoma.


Symptoms and Signs

About half of leiomyosarcomas are located in the retroperitoneal (retroabdominal) space or in the uterus. These tumors can present as an abdominal mass, abdominal pain, swelling, weight loss, nausea, vomiting, or vaginal bleeding. Leiomyosarcoma can also occur in other parts of the body as a progressive, often painless mass.



When a sarcoma is suspected, the initial evaluation includes either a CT scan or MRI. The diagnosis is confirmed by biopsy of the suspected area. The investigation may be completed by a thorax CT scan or PET scan. Sometimes, during hysterectomy for uterine fibroids, leiomyosarcoma may be found incidentally. After the evaluation, the cancer stage can be determined.



When leiomyosarcoma is localized, the treatment of choice is surgery to remove it completely. In some cases, radiation therapy before or after surgery may be necessary.

If metastases are found, chemotherapy is offered with the goal of controlling symptoms and disease progression. The preferred agents are: doxorubicin, gemcitabine-docetaxel, ifosfamide, liposomal doxorubicin, gemcitabine, and pazopanib. Clinical trials may also be explored.



After surgery, leiomyosarcoma patients will be closely monitored due to the risk of recurrence (when the cancer returns).