Leiomyosarcoma: Symptoms, Treatment & Prognosis

Leiomyosarcoma is a rare and aggressive type of soft tissue sarcoma that originates in the smooth muscle cells of the body. These muscles are found in the walls of organs such as the uterus, stomach, intestines, blood vessels, and kidneys. Though uncommon, leiomyosarcoma can develop anywhere smooth muscle is present. Early diagnosis and timely treatment are vital to improving outcomes and preventing metastasis.

Understanding Leiomyosarcoma

Leiomyosarcoma (LMS) accounts for approximately 10–20% of all soft tissue sarcomas. It can occur in both men and women, but is more common in middle-aged and older adults.

The disease develops when smooth muscle cells begin to grow uncontrollably, forming malignant tumours that can invade nearby tissues or spread (metastasise) to distant organs such as the lungs or liver. Because leiomyosarcoma can appear in different parts of the body, its symptoms and prognosis vary depending on the site of origin.

Leiomyosarcoma Symptoms

The symptoms of leiomyosarcoma depend on where the tumour develops. In many cases, early stages may not produce noticeable signs. However, as the tumour grows, the following symptoms may occur:

1. General Symptoms

• Unexplained weight loss
• Fatigue and weakness
• Persistent pain or swelling in the affected area
• A firm or growing lump beneath the skin

2. Uterine Leiomyosarcoma

Uterine leiomyosarcoma originates in the smooth muscle layer of the uterus (myometrium) and is often mistaken for benign fibroids.

Common symptoms include:

• Abnormal uterine bleeding (especially after menopause)
• Pelvic or abdominal pain
• Enlarged uterus or pelvic mass
• Frequent urination or constipation due to pressure on nearby organs

3. Leiomyosarcoma of the Kidney

Leiomyosarcoma of the kidney is extremely rare and aggressive. It often presents with:

• Flank or back pain
• Presence of blood in urine (hematuria)
• Abdominal lump or swelling
• Unintended weight loss

Because it can mimic other kidney tumours, accurate diagnosis through advanced imaging and biopsy is essential.

4. Metastatic Leiomyosarcoma

When leiomyosarcoma spreads to distant organs, symptoms depend on the site of metastasis:

• Lungs: Cough, shortness of breath, or chest pain
• Liver: Abdominal pain, jaundice, or swelling
• Bones: Persistent pain or fractures

Leiomyosarcoma Radiology and Diagnosis

Radiology plays a crucial role in diagnosing and staging leiomyosarcoma. Imaging studies help determine tumour size, location, and extent of spread.

1. Imaging Techniques

• MRI (Magnetic Resonance Imaging): Provides detailed images of soft tissues, helping to assess tumour margins and involvement of surrounding structures.
• CT Scan (Computed Tomography): Useful for detecting tumours in the abdomen, pelvis, or lungs. It also helps monitor disease progression.
• Ultrasound: Often used for uterine leiomyosarcoma detection or initial evaluation of abdominal masses.
• PET Scan (Positron Emission Tomography): Helps identify metastatic lesions throughout the body.

2. Biopsy

A biopsy is essential for definitive diagnosis. A small tissue sample from the tumour is examined under a microscope to confirm malignancy and determine the tumour grade.

Leiomyosarcoma Treatment

Treatment for leiomyosarcoma depends on several factors, including tumour size, location, stage, and whether it has spread. A combination of surgery, chemotherapy, and radiation therapy is often used for the best outcomes.

1. Surgery

Surgical removal of the tumour remains the primary treatment option. The goal is to remove the cancer completely with clear margins to prevent recurrence.

• Localised Leiomyosarcoma: Surgery can be curative if detected early.
• Uterine Leiomyosarcoma: May require hysterectomy (removal of the uterus).
• Renal Leiomyosarcoma: May involve nephrectomy (removal of the kidney).

2. Radiation Therapy

Radiation may be given before or after surgery to destroy remaining cancer cells. It helps reduce the risk of recurrence and control local disease.

3. Chemotherapy

Chemotherapy drugs are used to kill cancer cells or slow their growth, especially when the tumour cannot be completely removed or has metastasised.

4. Targeted Therapy and Immunotherapy

Ongoing research has introduced targeted treatments that focus on specific molecular changes in cancer cells. Immunotherapy may also help the immune system recognise and attack cancer cells more effectively.

Uterine Leiomyosarcoma

Uterine leiomyosarcoma is one of the most common subtypes of LMS. Though it accounts for less than 2% of uterine cancers, it is highly aggressive.

Diagnosis and Challenges

Because its symptoms resemble fibroids, it is often diagnosed after surgery for presumed benign growths. Early detection is challenging but crucial for better outcomes.

Treatment Options

• Surgery: Total hysterectomy is the standard treatment.
• Radiation or Chemotherapy: Used to control residual disease or metastasis.
• Follow-Up: Regular imaging and pelvic exams are essential to detect recurrence.

Metastatic Leiomyosarcoma

When leiomyosarcoma spreads to other organs, it becomes more difficult to treat. Metastatic leiomyosarcoma often affects the lungs, liver, or bones.

Treatment Approach

• Chemotherapy and targeted therapy are the main treatments for advanced disease.
• Palliative radiation helps relieve pain and control symptoms.
• Surgical removal of metastases may be considered in select cases to extend survival.

Although metastatic LMS is challenging, advances in treatment continue to improve quality of life and outcomes.

Prognosis of Leiomyosarcoma

The prognosis of leiomyosarcoma varies depending on several factors:

• Tumour size and grade (how aggressive the cells appear)
• Location and stage at diagnosis
• Completeness of surgical removal
• Presence of metastasis

Early-stage tumours have a better prognosis, while advanced or metastatic cases may require long-term management. Five-year survival rates range from 40% to 70% for localised disease, but are lower for metastatic leiomyosarcoma.

Regular follow-up imaging is critical to monitor for recurrence.

Comprehensive Care at SPARSH Hospital

At SPARSH Hospital, our approach to leiomyosarcoma care is multidisciplinary. From expert oncologists to the best nephrologists in Bangalore, our team provides holistic care that includes:

• Accurate diagnosis through advanced radiology
• Personalised treatment plans tailored to each patient’s needs
• Post-treatment monitoring to prevent recurrence
• Supportive therapies to enhance recovery and quality of life

For patients with leiomyosarcoma of the kidney, SPARSH offers access to the best nephrology hospital in Bangalore, where specialists ensure optimal kidney function during and after cancer treatment.

When to See a Doctor?

If you experience persistent pain, abnormal bleeding, or notice any unusual lump or swelling, it’s important to consult a healthcare professional immediately. Early diagnosis can significantly improve treatment outcomes.

Those in Bangalore can visit SPARSH Hospital, where expert oncologists and nephrologists offer comprehensive evaluation, accurate diagnosis, and advanced cancer care.

Conclusion

Leiomyosarcoma is a rare but serious cancer that requires early detection, accurate diagnosis, and comprehensive treatment. Whether it affects the uterus, kidney, or other organs, prompt medical attention is key to improving survival rates.

With expert oncologists, advanced imaging technology, and a patient-centric approach, SPARSH Hospital provides world-class care for patients with leiomyosarcoma — from diagnosis to recovery.

Frequently Asked Questions

What is leiomyosarcoma?

Leiomyosarcoma is a malignant tumour that originates from smooth muscle tissue. It can develop in organs like the uterus, kidneys, or blood vessels.

What are the common leiomyosarcoma symptoms?

Common symptoms include persistent pain, swelling, abnormal bleeding (for uterine cases), or a palpable mass.

How is leiomyosarcoma diagnosed?

Diagnosis involves imaging studies like MRI or CT scans, followed by a biopsy to confirm the cancer type.

What are the treatment options for leiomyosarcoma?

Treatment typically includes surgery, chemotherapy, and radiation therapy. In advanced cases, targeted therapy may also be used.

Can leiomyosarcoma spread to other organs?

Yes. Metastatic leiomyosarcoma can spread to the lungs, liver, or bones, requiring systemic treatment.

Where can I get treatment for leiomyosarcoma in Bangalore?

You can visit SPARSH Hospital, one of the leading cancer and nephrology centres in Bangalore, offering expert care for leiomyosarcoma and other rare cancers.