This tumor makes up for about 1-4% of all cancer type tumors of the uterus and about 30% of all uterus sarcomas. On average in the US there is about 50 cases of leiomyosarcoma of the uterus, with the middle age of appearance being 52-54 years of age. This is about 10 years after the expected time for the leiomyosarcoma to appear. In average, this tumor is about 8-10 centimeters in size.
This type of tumor also happens in smooth muscles of the stomach and intestines, being an extremely dangerous and painful disease, striking every patient with high intensity.
Clinically, leiomyosarcoma of the uterus appears with women who are in their postmenopausal age. Bleeding from the vagina is one of the most common symptoms which can be taken as the regular period. Quick grow of the uterus miasma is another exclusive symptom to this.
In order to confirm leiomyosarcoma you need to go through a couple of diagnostic methods, including a clinical checkup, an observation with the ultrasound, hysteroscopy and fractionated curettage. Definitive diagnosis is possible after hysterectomy or hysteroscopy procedure where the tumor is ablated.
Treatment is usually done surgically, consisting mostly of hysterectomy. After this treatment doctors may suggest radiation therapy, but in this postoperative stage radiation can also help develop some other conditions in the pelvis area with no significant improvements made to the survival of the patient. Systematic postoperative chemotherapy is therefore a much better solution as it can treat different stages of the disease.
Grading and metastatic potential
In estimates of the predictable biological behavior of these tumors the O’Connor-Norris index is used. Mitosis is counted on 10 visible segments due to the high zoom rate of the microscope (up to 400X) on the most active area on the tumor. Nuclear gradient is then determined based on the microscopic appearance of the core, chromatin and core. Leiomyosarcoma of the uterus is spread usually hematogenous. Vascular invasion can be found in about 25% of these tumors, mostly with metastases in the lungs.
A typical leiomyosarcoma survival rate for disease stages I and II is 40-75%, while stages III and IV are dropping down to 15-20%. A five year survival rate for all stages of the disease is about 40-45%. Leiomyosarcomas with these characteristics are usually discovered in I or an II stage, which is why the stage of the condition is the most important indicator of how the disease flows and how will it end.
Postoperative observation of the patients is of great importance. On a yearly basis, one should get a clinical control 5 to 6 times in the first two years after surgery. In this period about 80% of disease recidivisms are discovered. This includes clinical checkup, UV observation of the pelvis and abdomen, RTG scan of the lungs as well as CT/MRI of the pelvis and abdomen. By using all of these methods combined, there are higher chances of discovering any additional problems caused by this illness which need to be taken care of as soon as possible.