• Leiomyosarcoma

    Definition

    Leiomyosarcoma is a rare type of soft tissue cancer. This cancer starts in cells that make up smooth muscle which can be found throughout the body. These muscles control involuntary movement of organs, blood vessels, and skin.
    Leiomyosarcoma can develop in any smooth muscle, but is most common in the muscle of the uterus, abdomen, and pelvis.
    Female Reproductive Organs
    Copyright © Nucleus Medical Media, Inc.

    Causes

    Cancer occurs when cells in the body divide without control or order. Eventually these uncontrolled cells form a growth or tumor. These growths are malignant which means they can invade nearby tissues including the lymph nodes. Cancer that has invaded the lymph nodes can then spread to other parts of the body.
    Cancer growth occurs when there are problems in the DNA of cells. It is not clear exactly what causes these problems, but is probably a combination of genetics and environmental factors.

    Risk Factors

    Some genetic disorders are associated with an increased risk of leiomyosarcoma. Examples include:
    • Retinoblastoma—a rare type of cancer that affects the retina of the eye
    • Familial adenomatous polyposis—abnormal growth of adenomatous polyps in the colon and/or rectum that can transform into cancer
    • Neurofibromatosis type 1
    • Li-Fraumeni syndrome
    • Werner syndrome
    • Nevoid basal cell carcinoma syndrome (Gorlin syndrome)
    Other factors that may increase the chance of leiomyosarcoma include:
    • Past history of cancer treatment with radiation therapy or tamoxifen
    • Exposure to certain chemicals used to make plastics or weed killers

    Symptoms

    Leiomyosarcoma usually does not have symptoms. If present, symptoms will vary depending on the tumor’s location, size, and growth. As the tumor grows, it presses on nearby structures, causing problems. When they appear, general symptoms may include:
    • Swelling or a lump
    • Abdominal bloating
    • Abnormal vaginal bleeding
    • Shortness of breath
    • Pain
    • Numbness or muscle weakness

    Diagnosis

    You will be asked about your symptoms and medical history. A physical exam will be done. This includes a thorough examination of the affected area and blood tests.
    Imaging tests can help diagnose and determine the extent of cancer. Tests may include:
    A biopsy will help tell the difference between a noncancerous or cancerous growth. A tissue sample from the affected area is examined under microscope for the presence of cancer cells.
    The physical exam, combined with all of the test results, will help to determine the type, grade, and stage of cancer. Staging is used to guide a treatment plan. Leiomyosarcoma is staged from I-IV. Stage I is a cancer that has stayed in one area, while stage IV indicates a spread to other parts of the body. Cancer cells may also be graded by how fast they might grow and spread.

    Treatment

    Cancer treatment varies depending on the location, size, grade, and stage of the tumor, your age, and overall health. Since leiomyosarcoma is rare, treatment with a specialty team may be needed. A combination of treatments may be best.

    Surgery

    In most cases, leiomyosarcoma is treated with surgery. If the tumor is only affecting local tissue, it may be the only treatment that is needed. The cancerous tissue and a surrounding border of healthy tissue will be removed. Any affected lymph nodes near the tumor may also be removed. The exact type and extent of the surgery will depend on the location of the cancer.

    Radiation Therapy

    Radiation therapy is the use of radiation to kill cancer cells and shrink tumors. Radiation therapy may be:
    • External—radiation directed at the tumor from a source outside the body
    • Internal (brachytherapy)—radioactive materials placed into the body near the cancer cells
    Radiation therapy may be used to shrink cancer before surgery, to kill off any potential remaining cancer cells after surgery, or to reduce the size of tumors if surgery cannot be done.

    Chemotherapy

    Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy may be given in by IV, injection, or mouth. The drugs enter the bloodstream and travel through the body killing mostly cancer cells, but also some healthy cells.
    Chemotherapy may be used for leiomyosarcoma that has spread to other places in the body.

    Prevention

    There are no current guidelines to prevent leiomyosarcoma because the cause is not clear.

    RESOURCES

    American Cancer Society http://www.cancer.org

    Sarcoma Alliance http://sarcomaalliance.org

    CANADIAN RESOURCES

    Canadian Cancer Society http://www.cancer.ca

    Sarcoma Cancer Foundation of Canada http://sarcomacancer.ca

    References

    Leiomyosarcoma. Dana-Farber Cancer Institute website. Available at: http://www.dana-farber.org/Adult-Care/Treatment-and-Support/Leiomyosarcoma.aspx. Updated May 2, 2014. Accessed July 13, 2016.

    Leiomyosarcoma. The Liddy Shriver Sarcoma Initiative website. Available at: http://sarcomahelp.org/leiomyosarcoma.html. Updated April 2007. Accessed July 13, 2016.

    Leiomyosarcomas (LMS). MacMillian Cancer Support website. Available at: http://www.macmillan.org.uk/information-and-support/soft-tissue-sarcomas/leiomyosarcomas. Updated March 31, 2016. Accessed July 13, 2016.

    Uterine leiomyosarcoma. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 22, 2016. Accessed July 13, 2016.

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