Leiomyosarcoma (patient information)

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Editor-in-Chief: C. Michael Gibson, M.S.,M.D. [mailto:mgibson@perfuse.org] Phone:617-632-7753; Associate Editor-In-Chief:  Jinhui Wu, M.D.

Overview
Leiomyosarcoma is a kind of soft tissue sarcomas in internal organs which originates from smooth muscle cells. It may arise anywhere in the body, but is most common in the uterus, stomache, or intestines. Usual symptoms include a new lump or a lump that is growing anywhere on your body, abdominal pain or pelvic pain that is getting worse, blood in your stool or vomit, black, tarry stools and unusual vaginal bleeding. Treatments invlove surgery, radiation therapy, chemotherapy, palliative treatment or a combination. The prognosis of leiomyosarcoma is poor.

What are the symptoms of Leiomyosarcoma?
The symptoms of leiomyosarcoma depend on the location of the tumor. For the tumors always develope in gastrointestinal tract and uterus, usual symptoms are the following.


 * A new lump or a lump that is growing anywhere on your body


 * Abdominal pain


 * Pelvic pain
 * Hematemesis


 * Black, tarry stools


 * Unusual vaginal bleeding

Other health problems may also cause these symptoms. Only a doctor can tell for sure. A person with any of these symptoms should tell the doctor so that the problems can be diagnosed and treated as early as possible.

Who is at highest risk?
Clinical data has suggested that the development of leiomyosarcoma is related to radiation exposure. Other causes are not known for certain.

When to seek urgent medical care?
Call your health care provider if symptoms of leiomyosarcoma develop. If you experience either of the following symptoms, seeking urgent medical care as soon as possible:


 * Severe abdominal pain


 * A large amount of hematemesis


 * Shock

Diagnosis

 * Biopsy: It is the most important test for diagnosing leiomyosarcoma. During this peroid, the doctors remove a small amount of tissue for examination under a microscope. Then the pathologists may analyze the samples and tell whether the tissues is benign or cancerous.


 * Endoscopy and biopsy: It is the main test used to diagnose gastrointestinal tract leiomyosarcoma when patient's signs and symptoms suggest this disease may be present. After you are sedated, the doctor puts an endoscope which is a thin, flexible, lighted tube down your throat. Then the doctor can view the lining of your esophagus, stomach, and first part of the small intestine. If abnormal areas are noted, biopsies can be obtained through the endoscope. The tissue samples will be checked by the pathologists under a microscope to see whether sarcoma is present or not.


 * Hysteroscopy and endometrial biopsy: This is the most important test used to diagnose uterine leiomyosarcoma when signs and symptoms suggest this disease may be present. The gynecologist inserts a tiny telescope into the uterus through the cervixan and obtains abnormal samples. The tissue samples will be checked by pathologists under a microscope to see whether sarcoma is present or not.


 * Magnetic resonance imaging (MRI): An MRI uses magnetic fields but it is a different type of image than what is produced by computed tomography (CT) and produces detailed images of the body. Like computed tomography (CT), a contrast agent may be injected into a patient’s vein to create a better picture.


 * Computed tomography (CT) scan and biopsy: CT scans are often used to diagnose leiomyosarcoma. It can confirm the location of the sarcoma and show the organs nearby. These are helpful for determining the stage of the cancer and in determining whether surgery is a good treatment option. CT scans can also be used to guide biopsy and a biopsy sample is usually removed and looked at under a microscope.


 * Positron emission tomography (PET) scan: When doing this test, a small amount of a radioactive medium is injected into your body and absorbed by the organs or tissues. This radioactive substance gives off energy which in turn is used to produce the images. PET can provide more helpful information than either CT or MRI scans. It is useful to see if the sarcoma has spread to the lymph nodes and it is also useful for your doctor to locate where the sarcoma has spread.


 * Ultrasonography: This is an painless test which uses sound waves to create a picture of the internal organs. Because tumors generate different echoes of sound waves than normal tissue, the doctor can locate a mass inside the body.


 * Chest X-ray: This plain x-ray of your chest may be done to see if the sarcoma has spread to your lungs.


 * Whole Bone Scan: The goal of a whole body bone scan is to show if a sarcoma has metastasized to your bones.

Treatment options
Patients with leiomyosarcoma have many treatment options. The selection depends on the stage of the tumor. The options are surgery, radiation therapy, chemotherapy, or a combination of these methods. Before treatment starts, ask your health care team about possible side effects and how treatment may change your normal activities. Because cancer treatments often damage healthy cells and tissues, side effects are common. Side effects may not be the same for each person, and they may change from one treatment session to the next.


 * Surgery: The goal of surgery is to remove the tumor and some surrounding tissue to cure leiomyosarcoma.


 * Radiation therapy: This is a cancer treatment to kill cancer cells or keep them from growing by using high-energy x-rays or other types of radiation.


 * Chemotherapy: The treatment is to use drugs to stop the growth of cancer cells either by killing the cells or by stopping them from dividing. Usual drugs include ifosfamide and doxorubicin (Adriamycin).


 * Palliative treatment: This treatment is used for the patients whose cancer has spread. It may improve the patient's quality of life by controlling the symptoms and complications of this disease.

Diseases with similar symptoms

 * Peptic ulcer
 * Stomach cancer
 * Uterine cancer

Where to find medical care for Leiomyosarcoma?
Directions to Hospitals Treating Leiomyosarcoma

What to expect (Outlook/Prognosis)?
The prognosis of leiomyosarcoma is poor and it depends on the following:
 * Whether or not the tumor can be removed by surgery
 * The stage of the sarcoma: the size of the tumor, whether the sarcoma has spread outside the internal organ
 * The patient’s general health

Prevention
At present, there is no known way to prevent most cases. And for cancer patients receiving radiation therapy, there is usually little choice.

Source
http://www.cancer.gov/cancertopics/factsheet/Sites-Types/soft-tissue-sarcoma