Leiomyosarcoma Symptoms

What Is Leiomyosarcoma?

Leiomyosarcoma, or LMS, is a rare type of cancer. It grows in the smooth muscles. These smooth muscles are in the body's hollow organs, such as:

The intestines
Blood vessels
Stomach
Bladder

While the cancer is rare, it is also very aggressive. This means it can grow fairly quickly. Doctors find it often in the uterus or the abdomen [¹].

Types of Leiomyosarcoma

The three main types of Leiomyosarcoma are [²]:

Somatic Soft Tissue LMS is the most common type of Leiomyosarcoma. It affects the connective tissue of your body.

Subcutaneous or Cutaneous LMS is a rare type that affects your skin’s piloerector muscles. These muscles are in your skin and eyes. They are responsible for making your pupils dilate and giving you goosebumps.

LMS of a Vascular Origin is the rarest type of Leiomyosarcoma. It develops in blood vessels such as:

Peripheral arteries
Inferior vena cava
Pulmonary artery

How is Leiomyosarcoma Diagnosed?

Tissue biopsy of the primary tumor is the standard diagnostic method for Leiomyosarcoma [³]. Doctors perform it through a needle. They use it to obtain a sample of cells from the tumor. Following this, they send it for laboratory testing.

Leiomyosarcoma Staging

Doctors assign stages for Leiomyosarcoma after looking at the tumor size. Stages show how far the cancer has spread from the original location.

The stages of Leiomyosarcoma are [⁴]:

1A – The cancer is low-grade. The tumor size is less than 5 cm. The disease isn't metastatic.

1B – The cancer is low-grade. The tumor size is more or less than 5 cm. The disease isn’t metastatic.

2A – The cancer is low-grade. The tumor size is more or less than 5 cm. The disease isn’t metastatic.

2B – The cancer is high-grade. The tumor size is less than 5 cm. It can be superficial or deep. The disease isn't metastatic.

2C – The cancer is high-grade. The tumor size is more or less than 5 cm. It is superficial. The disease isn’t metastatic.

3 – The cancer is high-grade. The tumor size is more or less than 5 cm. It is deep. The disease isn't metastatic.

4 – The cancer can be any grade/any size/any location. The disease is metastatic.

Medical teams use these stages to design the right treatment course for patients. It also helps them give patients the most accurate prognosis.

Is Leiomyosarcoma Hereditary?

Medical experts haven’t been able to determine cancer’s causes. So, it doesn’t seem to have hereditary roots. But there are some conditions that they associate with Leiomyosarcoma. These conditions include:

Gardner syndrome
Nevoid basal cell carcinoma
Werner syndrome

Researchers believe that both genetic and environmental factors play a role in it [⁵].

Leiomyosarcoma Symptoms

Leiomyosarcoma symptoms can be subtle and may not always be tell-tale signs of cancer. Some patients are also asymptomatic.

What Are the Symptoms of Leiomyosarcoma?

Common symptoms of Leiomyosarcoma include:

Fever
Pain
Fatigue
Nausea
Vomiting
Sudden weight loss
Swelling near the tumor
A lump under the skin

What Are Some Signs of Leiomyosarcoma?

In the beginning, it may appear as a painless lump in the body's soft tissues. There may be pain or cramping in an internal organ, such as:

The uterus
The digestive tract

Symptoms don’t involve the bones except in serious cases.

Early signs can also include

Weight loss
Pain
Fever
Nausea, etc.

Symptoms of Leiomyosarcoma In Women vs. Symptoms of Leiomyosarcoma In Men*

Many women remain asymptomatic. The symptoms they may experience include [⁶]:

Abnormal bleeding from the uterus
Bleeding from the vagina

Postmenopausal bleeding can also indicate uterine Leiomyosarcoma.

They may also experience the following:

Unusual vaginal discharges
Pain affecting the stomach/pelvis
Change in bowel habits

It’s important to note that uterine leiomyosarcomas are malignant. This means they may spread locally and to other areas of the body. They may especially affect the liver and lungs. They can also cause life-threatening complications.

This cancer is more common in women than in men. For men, the symptoms may not be apparent at first. Some clues to look out for are:

Lumps
Swelling as the tumor grows
Pain if the tumor squeezes a muscle or a nerve

Risk Factors for Leiomyosarcoma

Those over the age of 50 are at high risk of getting LMS. Other risk factors include:

Immunosuppressive drugs
Human immunodeficiency virus (HIV)
External radiation therapy
Thorotrast (a contrast X-ray dye that is no longer used)
Chlorophenols
Androgen-anabolic steroids
Alkylating agents
Dioxin
Human herpesvirus type 8 (Kaposi sarcoma)
Arsenical pesticides and medications
Vinyl chloride
Hormonal factors
Thyroid disorders
Autoimmune diseases
Post-transplant immunosuppression
Smoking
Cyclophosphamide
Chronic repair processes
Damaged lymph system

Leiomyosarcoma Prevention

The best preventiion method for soft tissue sarcomas is to avoid exposure to certain risk factors. But sometimes, this cancer can also develop in people with no risk factors. So, there isn’t a standard way to prevent it at the moment. Even with radiation therapy, some people have no choice but to get it.

Leiomyosarcoma Prognosis and Treatment

Like most cancers, leiomyosarcoma prognosis is also tricky. If a doctor identifies it early, they can remove it by surgery. In this case, the prognosis is good. Full recovery is also possible. But if LMS is malignant, treating it gets tricky. In this case, the prognosis is not promising [⁷].

Leiomyosarcoma Survival Rate

40 out of every 100 people with Leiomyosarcoma of the digestive system survive it for 5 years or more. Around 40 out of every 100 women with Leiomyosarcoma survive their cancer for 5 years or more after diagnosis.

Leiomyosarcoma Treatment Options

Your healthcare provider will plan a treatment course after a thorough assessment. They will determine the size and location of your Leiomyosarcoma. They will also find out if it has spread to other areas. Then, they will create a treatment plan after considering your health and preferences.

The most common treatments for Leiomyosarcoma include:

Radiation therapy makes use of energy beams to kill cancer cells. During this session, your doctor asks you to lie on a table. Then, a machine moves around you and directs the energy beams into your body. But radiation therapy is a secondary approach.

The primary approach is surgery. During surgery, the goal is to remove as much of the tumor as possible. But it may not be possible if the cancer is malignant. In such cases, the surgeon removes however much is possible.

Chemotherapy uses strong chemicals to kill cancer cells. But doctors only recommend it if the surgery has failed. They may also recommend it if the cancer has spread to other parts of the body.

Common chemotherapy drugs include:

Docetaxel (Taxotere)
Gemcitabine (Gemzar)
Trabectedin (Yondelis)
Liposomal doxorubicin (Myocet) – for people who can’t have doxorubicin
Epirubicin (Pharmorubicin)
Dacarbazine – mainly for Leiomyosarcoma

Chemotherapy also has side effects. For one, it damages healthy cells while killing cancer cells. These side effects may occur at any time during, immediately, or after chemotherapy.

Some side effects can also develop years later. While most are temporary, some can also be permanent. They depend on the drug, its dosage, and the patient's overall health.

Common chemotherapy side effects include [⁸]:

Vomiting
Nausea
Loss of appetite
Fatigue
Sore throat and mouth
Hair loss
Heart issues
Tingling or numbness of the toes and fingers
Low count of blood cells

Some therapies focus on specific abnormalities in cancer cells. One of them is targeted drug therapy. It blocks these abnormalities and causes the cancerous cells to die. But it’s rarely an option. Doctors may recommend it for advanced Leiomyosarcoma. Doctors usually test cancer cells to decide if this approach is suitable.

Conclusion

Takeaway

Leiomyosarcoma is a life-threatening disease. While it’s rare, malignant forms of this cancer can be fatal. It’s important to consult an oncologist who is familiar with the disease. The pathologic diagnosis is challenging. In some cases, an expert pathologist may also review the biopsy in detail. Complete staging is important before creating a treatment course. With accurate staging and diagnosis, the prognosis may be better than otherwise.