Leiomyosarcoma

Leiomyosarcoma is a tumor that often goes undetected at first. However, early diagnosis can increase the chances of a cure.

What is Leiomyosarcoma?

Due to its comparatively unspecific symptoms, a leiomyosarcoma is often only diagnosed incidentally. The tissue of the malignant tumor cannot always be immediately distinguished in the laboratory from that of the benign leiomyoma. See AbbreviationFinder for abbreviations related to Leiomyosarcoma.

A leiomyosarcoma is a comparatively rare malignant tumor on the so-called smooth muscles (which cannot be controlled voluntarily).

While leiomyosarcoma is present in about 1 in 100 cases of a malignant (cancerous) growth of the uterus, the tumor can form in almost any smooth muscle part of the body. Depending on the malignancy of a leiomyosarcoma, different forms of new tissue formation (of the tumor) can be distinguished – for example, the low-grade leiomyosarcoma is one of the comparatively less dangerous forms.

Leiomyosarcoma usually occurs after the age of 30. The malignant tumor most commonly affects people in their 6th decade of life.

Symptoms associated with a leiomyosarcoma are usually not very specific – in the uterus the sarcoma often leads to rapid organ enlargement and bleeding.

Causes

With regard to the specific causes of a leiomyosarcoma, there are still various uncertainties in medicine.

Contrary to what was assumed in earlier medical studies, according to current knowledge, leiomyosarcoma does not develop as a degeneration of leiomyoma (a benign tumor of the smooth muscles). Risk factors that promote the development of a so-called endometrial carcinoma (a malignant tumor of the uterus) can be largely ruled out for leiomyosarcoma – corresponding factors include, for example, obesity, diabetes mellitus, hypertension (high blood pressure) and childlessness.

Since leiomyosarcoma occurs more frequently in patients who are in their 6th decade of life, bodily processes that increasingly take place during this lifespan probably play a role in the development of the tumor.

Symptoms, Ailments & Signs

In most cases, the symptoms of a leiomyosarcoma are relatively clear and therefore point directly to the disease. For this reason, an early detection and treatment of this disease is possible. Those affected suffer from the formation of tumors, which occur primarily in the abdominal area.

The abdomen enlarges enormously and severe abdominal pain occurs. In many cases, the leiomyosarcoma also damages the patient’s liver, resulting in severe liver pain or jaundice. The patients also have kidney diseases and can die from these in the worst case. The legs often also swell, which restricts movement and thus the everyday life of the person concerned.

The life expectancy of the patient is significantly reduced and limited by the leiomyosarcoma. Should metastases form, cancer can develop in other areas of the body and weaken the body. The complaints and symptoms depend heavily on the affected region. It is not uncommon for the disease to also lead to psychological complaints or upsets, so that many patients also develop depression.

Diagnosis & History

Due to its comparatively unspecific symptoms, a leiomyosarcoma is often only diagnosed incidentally. The tissue of the malignant tumor cannot always be immediately distinguished in the laboratory from that of the benign leiomyoma.

Characteristically, however, the leiomyosarcoma shows a high diversity of cells and a characteristically increased cell division rate under microscopic examination. A leiomyosarcoma of the uterus has a comparatively poor prognosis on average. However, the course of the disease depends on factors such as the severity of a tumor and the presence of metastases (a spread of malignant tumor cells).

A leiomyosarcoma that has a diameter of less than 5 centimeters usually takes a more favorable course than larger tumors. The low-grade leiomyosarcoma usually shows a relatively favorable course of the disease with slower disease progression.

Complications

Since leiomyosarcoma is a tumor, it is always associated with complications. In the worst case, the tumor can lead to the death of the affected person if it is not discovered until late and treatment is therefore delayed. In many cases, however, leiomyosarcoma does not show any characteristic complaints and symptoms, so that unfortunately the diagnosis is often made late.

Those affected suffer from an enlarged liver and abdominal pain. Jaundice also occurs and patients may suffer from kidney problems. In the worst case, this leads to kidney failure, in which the affected person is dependent on dialysis or a donor kidney in order not to die. The legs can also be swollen and painful due to the leiomyosarcoma.

During treatment, the tumor is removed. Usually there are no complications. However, chemotherapy can have various side effects that can reduce the quality of life. In some cases, however, the life expectancy of the patient is reduced by the leiomyosarcoma if there is no positive course of the disease.

When should you go to the doctor?

If abdominal enlargement or any other sign of a serious condition is noticed, a doctor must be consulted. The symptoms indicate that a leiomyosarcoma has formed. If kidney disease or swelling in the legs becomes noticeable, the condition may already be advanced. At this point at the latest, the family doctor or a dermatologist must be consulted, who can clarify the symptoms and, if necessary, suggest treatment.

If metastases have already formed, treatment must be initiated immediately. The affected person must immediately go to the nearest doctor’s office and have typical symptoms such as skin lumps, coughing up blood or stomach cramps clarified. If psychological problems have developed alongside the tumor, a therapist must also be consulted. Leiomyosarcoma is a serious condition that always needs to be evaluated and treated by a doctor. People suffering from high blood pressure or diabetes mellitus are particularly susceptible. The same goes for people who are overweight and women without children. If you belong to one of these risk groups, it is best to consult a doctor immediately if you experience the symptoms mentioned.

Treatment & Therapy

In order to successfully treat a leiomyosarcoma, it is usually necessary to surgically remove the tumor. This necessity is due to the fact that the malignant tissue formation in most cases does not respond to the desired extent to conservative (non-surgical) treatment methods such as radiotherapy or chemotherapy.

However, since leiomyosarcoma is a relatively rare type of tumor, which can also take many different forms, the necessary treatment steps are usually based on the individual case. If a leiomyosarcoma has already formed metastases in neighboring tissue, these too require surgical removal if medically possible.

It is not uncommon for a woman ‘s ovaries to be affected by metastases from a leiomyosarcoma of the uterus. If this is the case, depending on the individual clinical picture, doctors often recommend a complete removal of the ovary. Such an intervention can reduce the risk of parts of the metastasis remaining in the ovaries.

If, in the case of a leiomyosarcoma, the lymph nodes are affected by metastasis, removing the lymph nodes (in contrast to the removal of affected ovaries) has so far usually not contributed to the healing success – this is why a corresponding intervention is usually avoided.

Outlook & Forecast

The prognosis for leiomyosarcoma depends on the stage of diagnosis, the start of therapy and the general state of health of the person concerned. If left untreated, the cancer cells spread in the organism and the tumor grows. Ultimately, the person concerned is at risk of premature death.

The more advanced the disease is, the worse the prognosis will be. If metastases have already formed in the body, the chance of recovery is significantly reduced. Cancer therapy is needed, which is associated with numerous side effects and risks. Due to the large number of complaints, the impairment of quality of life and the course of the disease, secondary diseases often occur. The emotional burden is unmanageable for many and therefore the risk of mental illness is increased.

If the tumor can be completely removed during an operation, the future prospects improve. Subsequent chemotherapy aims to prevent the new formation of cancer cells. If there are no further complications, recovery is possible. Despite an achieved cure, a new formation of the tumor can take place in the course of life. In most patients, the recurrence of symptoms worsens the prognosis. The body’s own immune system is often weakened to such an extent as a result of previous experiences that renewed healing is made more difficult.

Prevention

Since the exact causes of a leiomyosarcoma are currently largely unknown, it is hardly possible to prevent the disease. However, regular medical check-ups can help to diagnose leiomyosarcoma at an early stage.

Early visits to the doctor in the event of unusual symptoms such as cycle-independent bleeding in the uterus or bleeding despite the end of the menopause (the absence of menstrual bleeding due to age or development) serve to detect a possible leiomyosarcoma at an early stage – in this way further tumor growth can be prevented with the help of appropriate treatment steps.

Aftercare

In most cases, the options for follow-up care for leiomyosarcoma are significantly limited. First and foremost, early detection of the disease is important so that no further complications and symptoms can occur. As a rule, self-healing cannot occur with leiomyosarcoma either, so that the affected person should consult a doctor as soon as the first symptoms and signs of the disease appear.

In the worst case, the tumor spreads throughout the body and ultimately leads to the death of the affected person. Most of those affected are dependent on a surgical procedure in which the tumor is removed. The person concerned should rest and rest after the procedure in any case. Physical exertion or other stressful activities should be avoided in order not to expose the body to unnecessary stress.

Furthermore, even after a successful removal of the leiomyosarcoma, regular checks and examinations by a doctor are necessary so that other tumors can be recognized and removed at an early stage. Due to the illness, many of those affected are dependent on the support of their own families in their everyday lives. The leiomyosarcoma may also reduce the life expectancy of those affected, with the further course depending heavily on the time of diagnosis.

You can do that yourself

The possibilities for self-help are very limited in the case of a leiomyosarcoma. The focus here is on the early detection and treatment of the tumor, as this can prevent metastasis.

In the case of chemotherapy, patients need a lot of support in their everyday life. The support should not only take place on a physical level, but also on a psychological level. Conversations with familiar or close people can have a positive effect on possible psychological complaints or depression. Children should always be fully informed about the disease in order to avoid mental disorders. Furthermore, those affected must always be supported in their everyday life in order to avoid unnecessary strain on the body. Above all, help from friends or relatives always has a positive effect on the patient’s state of health.

In addition to chemotherapy, some of those affected also need radiation or surgery to remove the tumour. Complete healing is not always achieved. Contact with other affected patients can often have a positive effect on the course of the disease and the patient’s quality of life.

Leiomyosarcoma