Leiomyosarcoma

What is leiomyosarcoma?

Leiomyosarcoma is a malignant tumor that develops from smooth muscle cells, is characterized by rapid growth and the ability to metastasize in the early stages of its development. The disease can occur in any organ where there is smooth muscle, but most often it is found to be uterine leiomyosarcoma and soft tissue leiomyosarcoma, which is usually localized in the abdomen.

Leiomyosarcoma is a rare malignant neoplasm that most often occurs between the ages of 40 and 60 years. It occurs twice as often in women as in men. The exact reasons for the development of pathology are currently unknown. However, it has been proven that predisposing factors include hereditary predisposition and exposure to radiation.

This is a rather dangerous disease that is difficult to treat. In addition, more than half of the cases after treatment for leiomyosarcoma develop a relapse. However, in modern clinics specializing in the treatment of leiomyosarcoma, the latest treatment methods are used, which make it possible to effectively combat the pathology even in the later stages and in the event of a relapse. The MedTour platform will help you find an advanced clinic with experienced oncologists specializing in the treatment of leiomyosarcoma.

Symptoms and signs of leiomyosarcoma

Symptoms can vary significantly depending on the location of the pathology. But there are also a number of common symptoms that are typical for this disease:

• nausea and loss of appetite;
• sudden weight loss;
• bleeding;
• anemia;
• general weakness;
• nervousness;
• low-grade fever;
• pain in the area of tumor development.

In addition, each type of leiomyosarcoma has its own specific symptoms.

Types of leiomyosarcoma and specific symptoms

Depending on the organ in which leiomyosarcoma is found, oncologists distinguish the following types:

• Uterine leiomyosarcoma. It leads to an increase in the size of the uterus, accompanied by excessive discharge during menstruation. As the pathology develops, symptoms of ascites appear. In approximately a quarter of women with leiomyosarcoma of the uterine body, the disease is accompanied by thrombophlebitis or thrombosis. When the tumor metastasizes to the spine, pain is observed in the affected area; when it metastasizes to the liver, symptoms of jaundice appear. If metastases penetrate the lungs, then symptoms of pleurisy occur.
• Leiomyosarcoma of the vulva. When a tumor develops in the superficial layers of the vulva, it looks like the formation of a painful node that becomes covered with ulcers. If the tumor grows in deep layers, there are usually no specific symptoms. As such a sarcoma develops, metastases are diagnosed in the lungs and retroperitoneal lymph nodes.
• Leiomyosarcoma of the scrotum. First, lumps appear in the genital area, which do not cause any concern. As the disease progresses, a feeling of heaviness appears, ulcers and bleeding occur. When the tumor metastasizes, pain in the back, discomfort in the lower abdomen, swelling of the legs, shortness of breath, decreased libido, and impotence are recorded.
• Leiomyosarcoma of the bladder. As this tumor grows, problems with urination occur. There is blood in the urine, and blood clots may block the flow of urine. Leiomyosarcoma of the bladder is characterized by pain in the lower abdomen.
• Leiomyosarcoma of the gastrointestinal tract. The growth of this type of tumor is accompanied by nausea, loss of appetite and weight. The patient complains of pain in the stomach, heartburn, belching, and flatulence. Blood and pus may appear in the stool. The process of defecation is disrupted, obstruction may develop, rupture of the intestinal walls may occur, which may result in peritonitis.
• Leiomyosarcoma of the spleen. Characteristic symptoms are nausea, vomiting and thirst. The patient may feel pain when pressing on the spleen area. The volume of urine excreted increases. The development of pathology can lead to rupture of the spleen.
• Leiomyosarcoma of the retroperitoneum. It can lead to poor circulation in the area where the tumor compresses the blood vessels, and pain often occurs due to compression of the nerve endings. As a result of impaired blood supply to the liver, symptoms of ascites may appear, and with pressure on the inferior vena cava, swelling and blue discoloration of the lower extremities may appear.
• Leiomyosarcoma of the limb muscles. In the first stages it is asymptomatic. As the pathology develops, pain and ulcers may appear. The tumor can metastasize to the lungs, liver or bones.
• Leiomyosarcoma of subcutaneous fat. It is accompanied by the appearance of dense, protruding subcutaneous tumors. In the affected areas, the color of the skin changes and ulcerations may appear. Metastases penetrate the lungs and bones.
• Leiomyosarcoma of the skin. A characteristic feature of this type of pathology is the appearance on the skin of painful yellow, red or blue plaques that have clear edges. Neoplasms can be either single or multiple; they are prone to proliferation and ulceration. If skin leiomyosarcoma grows deeper, it can metastasize to the lungs.

Stages of leiomyosarcoma

Doctors distinguish four stages of this malignant disease:

• 1st stage. Cancer cells are localized in the muscle layer in which the pathology arose.
• 2nd stage. The tumor is actively growing, but is spreading only in one organ.
• 3rd stage. The size of the tumor increases and it grows into nearby lymph nodes or nearby tissues.
• 4th stage. Secondary foci of the malignant process (metastases) form in distant organs.

Diagnosis of leiomyosarcoma

If leiomyosarcoma is suspected, doctors prescribe a comprehensive examination, which includes laboratory tests and instrumental diagnostics. Tests may vary depending on the type of tumor and its location.

The most commonly used diagnostic methods include:

• MRI and CT. With their help, it is possible to accurately determine the size and location of the tumor and identify metastases.
• Laboratory tests. General tests of blood, urine, feces, blood biochemistry, and special tests to check specific indicators may be prescribed.
• Biopsy. This method makes it possible to make a definitive diagnosis and differentiate leiomyosarcoma from other tumors. This procedure involves collecting tumor cells and then studying them in the laboratory. The method of tissue collection may vary depending on the location of the tumor. The biopsy can be taken using a special needle under CT guidance, and the procedure can be performed laparoscopically or by other methods.

The latest methods for diagnosing malignant diseases

Special genetic testing is worth mentioning separately. This is the latest diagnostic method that allows to identify hereditary and acquired mutations associated with cancer, as well as determine specific markers for a particular type of cancer. This approach makes it possible to make a diagnosis as accurately as possible and select treatment that will be most effective in each specific case.

To learn more about laboratory diagnostics of malignant diseases in different countries, please contact the MedTour coordinating doctor through the contact form.

How many years do people live with leiomyosarcoma?

If this malignant disease is left untreated, on average people live about one year after diagnosis. However, after surgical removal of the tumor, the five-year survival rate is more than 60%.

Unfortunately, in most cases the tumor is diagnosed in late stages and surgery is no longer possible. However, if an accurate diagnosis is made and the latest treatment methods are applied, even in the later stages there is a chance to effectively combat the disease.

Treatment of leiomyosarcoma

Once leiomyosarcoma is diagnosed, treatment may involve a variety of approaches. The most effective is a personalized approach, when treatment methods are selected taking into account the type of leiomyosarcoma, its size, stage and other characteristics.

Operation

Surgical removal of the tumor is considered the priority treatment option. If possible, the tumor is removed completely, with additional excision of nearby tissue to reduce the likelihood of recurrence. Nearby lymph nodes in which metastases have appeared can also be removed.

In modern medical centers, such operations are performed in operating rooms equipped with the latest equipment; robotic surgery can be used. This allows surgical intervention to be performed with maximum precision and achieve good results.

Radiotherapy

For leiomyosarcoma, different types of radiation therapy can be used. Traditional external beam radiation therapy is usually given before surgery to reduce the size of the tumor. In addition, it can be used as palliative care in later stages.

Brachytherapy is often used for leiomyosarcoma. In this case, a radioactive element is placed near the tumor. This affects the tumor with fairly high doses of radiation without having a strong negative effect on other parts of the body.

Chemotherapy

Chemotherapy involves the use of drugs that slow tumor growth and destroy malignant cells. Chemotherapy can be used in combination with surgery or radiotherapy. For example, in the final stages of uterine leiomyosarcoma, treatment may include chemotherapy and radiation.

Targeted therapy

The use of targeted drugs in the treatment of malignant tumors makes it possible to have a targeted effect on malignant cells. When using drugs belonging to this class, healthy tissues are not negatively affected.

However, in order to correctly select targeted agents, accurate diagnosis is necessary to determine the histological type of the tumor. Such diagnostics can be done in specialized laboratories.

The MedTour coordinator will help you find clinics that offer individual selection of treatment and use the latest targeted drugs.

Immunotherapy

Various immunotherapy methods can be used for leiomyosarcoma. For this purpose, special hormonal agents may be prescribed. In addition, cancer vaccines can be used for malignant soft tissue tumors. Their use makes it possible to activate the immune response and eliminate the body’s tolerance to tumor antigens. Such vaccines are made individually for each patient, since to create them it is necessary to have tumor cells.

Antitumor vaccines can be used simultaneously with other treatment methods; they improve the effectiveness of therapy and significantly reduce the likelihood of relapse and metastases.

To learn more about immunotherapy options and the use of cancer vaccines for your specific case, please contact us.

Leiomyosarcoma – prognosis

According to statistical data for leiomyosarcoma, the prognosis for five-year survival is approximately:

• 50-65% for the first stage;
• 20-50% for the second and third stages;
• 10-40% for the fourth stage.

However, it is important to remember that this is general data. The individual prognosis may vary markedly depending on the type of tumor, the characteristics of its location, the general health of the patient and treatment methods. If the most modern treatment methods are used and a personalized approach is used, the prognosis can improve markedly.

The best clinics for the treatment of leiomyosarcoma

We cooperate with leading medical institutions in the world that treat malignant diseases, have special equipment for accurate diagnosis and modern treatment, and use the latest techniques. You can view the list of the best clinics for the treatment of leiomyosarcoma on our website yourself. To get more detailed information about medical centers, the doctors who work there and the techniques that are used, contact us. The coordinating doctor will help you figure it out, tell you about the nuances of treatment in different clinics and help you make the best choice of a medical institution taking into account your medical needs.

The best specialist doctors for the treatment of leiomyosarcoma

Would you like to find a good specialist for the treatment of leiomyosarcoma? The MedTour coordinator doctor will advise you on this issue for free, tell you about the best doctors in different countries, and advise on prices for consultation and treatment with leading specialists in this field. Contact us to receive information on all your questions.

Published: 09.11.2023

Updated: 10.11.2023

Medical author, Medical editor:

Natalia Segen

Medical author, Medical editor:

Olena Kursabaieva