Sarcoma

Leiomyosarcoma

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Leiomyosarcoma

  • See Also
  1. Uterine Leiomyoma
  2. Soft Tissue Mass
  • Epidemiology
  1. Onset typically over age 55 years (although younger ages may be affected)
  • Pathophysiology
  1. Aggressive, Smooth Muscle connective tissue tumor
  2. Neoplastic spindle cell proliferation
  3. Malignant variant of leiomyoma (e.g. Uterine Fibroid)
    1. May represent up to 0.23% of Uterine Fibroids
    2. Identified in 13 of every 10,000 women undergoing surgery for preseumed fibroids
  • Risk Factors
  • Uterine Leiomyosarcoma
  1. Age over 45 years old (OR 20)
  2. Post-Menopause (OR 9.7)
  3. History of pelvic radiation
  4. Tamoxifen use
  5. Genetic Syndromes (hereditary Retinoblastoma, Li-Fraumeni Syndrome)
  • Findings
  1. Expanding mass on the limbs, head, neck, Abdomen or retroperioneum
  2. Symptoms are related to location of mass (e.g. Abdominal Pain)
  • Imaging
  1. CT with Contrast
    1. Heterogeneous mass
  2. MRI Findings (Uterine Leiomyosarcoma )
    1. Intramural Hemorrhage (OR 21)
    2. Endometrial thickening (OR 11)
    3. T2-Weighted signal heterogeneity (OR 10)
    4. Non-myometrial origin (OR 4.9)
    5. Tomassin-Naggara (2013) Eur Radiol 23(8):2306-14 [PubMed]
  • Management
  1. Refer for core needle biopsy and surgical resection
  • References
  1. Achar (2022) Am Fam Physician 105(6): 602-12 [PubMed]
  2. Keating (2025) Am Fam Physician 112(4): 393-400 [PubMed]