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Uterine leiomyosarcoma

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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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)

Reference:


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