The information on this website is not intended for diagnosis or treatment. Please consult your physician for health concerns.

+90 850 321 50 00

Uterine Leiomyosarcoma

Aggressive smooth muscle malignancy of the uterus

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Kadın Hastalıkları ve Doğum department. Book Appointment →

What is Uterine Leiomyosarcoma?

Uterine leiomyosarcoma (LMS) is a malignant tumor arising from the smooth muscle of the myometrium, distinct from benign leiomyomas (fibroids).

It is the most common uterine sarcoma, comprising about 30 percent of uterine sarcomas, with an incidence of 0.4 per 100,000 women.

LMS typically occurs in women aged 50–60, but can occur at any age including premenopausal women.

Distinguishing LMS from benign fibroids preoperatively is unreliable; sarcoma should be suspected with rapid growth, postmenopausal growth, atypical imaging features or atypical clinical findings.

Even early-stage LMS confined to the uterus has a 5-year survival of about 50 percent due to high rates of recurrence and metastasis.

Symptoms

Abnormal uterine bleeding, often heavier or irregular than typical fibroid-related bleeding
Rapidly enlarging uterine mass, especially in postmenopausal women
Pelvic pain, pressure or discomfort
Pelvic mass on examination, sometimes with rapid growth
Constitutional symptoms in advanced disease: weight loss, fatigue, malaise
Symptoms of metastasis: lung (cough, dyspnea), abdominal mass, bone pain, neurologic symptoms
Postmenopausal bleeding always warrants evaluation

Risk Factors

Postmenopausal age (most common 50–60)
Tamoxifen use (associated with both benign and malignant uterine pathology)
Pelvic radiation history
Hereditary leiomyomatosis and renal cell cancer syndrome (FH gene mutation, rare)
Black race (higher incidence and worse outcomes)
Rapid growth of presumed fibroid in postmenopausal woman
Atypical features: irregular borders, central necrosis, restricted diffusion on MRI

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Postmenopausal vaginal bleeding (always evaluate)
  • Rapidly growing uterine mass, especially after menopause
  • Pelvic mass with severe pain or pressure
  • Heavy or irregular uterine bleeding unresponsive to typical management
  • New abdominal mass, lung symptoms or unexplained weight loss in patient with known uterine mass
  • Suspected sarcoma on imaging or histology
  • Recurrence symptoms during follow-up of treated LMS

Treatment Methods

01
Pre-operative imaging: pelvic MRI (preferred for distinguishing fibroids from sarcoma — features suggesting LMS include high T2 signal, low ADC values, central necrosis, irregular borders)
02
Endometrial biopsy if abnormal bleeding, although biopsy is often nondiagnostic for LMS
03
Avoid morcellation in any case of suspected uterine malignancy — significantly worsens outcomes
04
Total abdominal hysterectomy with bilateral salpingo-oophorectomy as primary treatment for confined disease
05
En bloc resection without disruption of tumor capsule
06
Lymphadenectomy not routinely performed; selective biopsy of clinically suspicious nodes
07
Adjuvant therapy: gemcitabine plus docetaxel chemotherapy for high-risk early-stage and advanced disease (controversial benefit)
08
Pelvic radiation may improve local control but not overall survival
09
Hormonal therapy (aromatase inhibitors) for ER/PR-positive LMS, particularly in postmenopausal women
10
Surgical metastasectomy for isolated lung or other oligometastatic recurrences
11
Systemic therapy for metastatic disease: doxorubicin, gemcitabine-docetaxel, trabectedin, pazopanib
12
Long-term surveillance with imaging every 3–6 months for first 2 years due to high recurrence risk

Which Department to Visit?

You can visit our Kadın Hastalıkları ve Doğum department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Kadın Hastalıkları ve Doğum Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

Book AppointmentContact Us

Related Health Topics

Other articles from the same department you may want to explore.

Regular Gynecological Check-up

Kadın Hastalıkları ve Doğum

Regular gynecological check-ups enable early diagnosis of many women's diseases and increase treatment success. It is recommended that every sexually active woman or woman over 21 see a gynecologist at least once a year.

Cervical Cancer

Kadın Hastalıkları ve Doğum

Cervical cancer develops from uncontrolled growth of cells in the cervix and is among the most common women's cancers worldwide. Precancerous lesions can be recognized with regular Pap smear and HPV testing.

HPV and Vaccination

Kadın Hastalıkları ve Doğum

HPV is a common virus transmitted sexually that can lead to certain types of cancer. Vaccination provides over 90% protection against high-risk HPV strains.

Ovarian Cyst

Kadın Hastalıkları ve Doğum

Ovarian cysts are fluid-filled sacs that form in or on the ovarian tissue. Most are asymptomatic and disappear spontaneously; however, large or complex cysts can cause pain and complications.

Endometriosis

Kadın Hastalıkları ve Doğum

Endometriosis affects about 10% of women of reproductive age, causing cyclic pelvic pain, dysmenorrhea, dyspareunia, and infertility; combined medical and laparoscopic treatment improves quality of life.

Uterine Fibroids

Kadın Hastalıkları ve Doğum

Uterine fibroids are benign tumors developing from the uterine muscle layer. They affect 20-50% of women of reproductive age; most are asymptomatic, but can cause bleeding and pain.

Polycystic Ovary Syndrome (PCOS)

Kadın Hastalıkları ve Doğum

PCOS is the most common endocrine disease affecting approximately 10% of women of reproductive age, characterized by androgen excess, ovulation disorder, and polycystic ovarian appearance.

Menopause

Kadın Hastalıkları ve Doğum

Menopause is the life stage defined by not having a period for 12 consecutive months and the natural cessation of ovarian function. The average age is 51, but it can vary between 45-55 years.

Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.