uterine leiomyosarcoma
Last reviewed 01/2018
Is a rare neoplasm of the uterus
- annual incidence is around 0.64 per 100,000 women
- accounts for <5% of all uterine malignancies and approximately 30% of all uterine sarcomas
- majority are seen in women over 40 years of age
Early hematogenous spreads is common. Leiomyosarcomas are considered as neoplasms of high metastatic potential with 5-year overall survival rates varying between 0% and 73%.
Patients usually presents with abnormal vaginal bleeding and pelvic pain
- clinically they may be difficult to differentiate from fibroids.
- this is especially important in fibroids which are untreated or managed conservatively
- a meta analysis reported that a diagnosis of leiomyosarcomas was made in about 2.94 per 1000 women (1in 340 women) who underwent surgery for supposed benign fibroids
Treatment options include:
- total abdominal hysterectomy and debulking of tumour if present outside the uterus
- ovaries may be preserved in premenopausal women with early stage leiomyosarcoma
- radiotherapy may help to control local recurrence
- advanced or recurrent disease, doxorubicin or docetaxel/gemcitabine can be used
A retrospective study revealed a 5-year disease-free survival rate was 55% (3)
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