Leiomyosarcoma: 7 facts about this rare soft tissue cancer

Soft tissue sarcoma begins in the soft – or connective – tissues of the body, such as muscle, fat and blood vessels. There are dozens of  types of soft tissue sarcoma.  One of the more common subtypes of sarcoma in adults is leiomyosarcoma. But with an estimated incidence of 1 in 100,000 people per year, it’s still quite rare compared to lung or colorectal cancer. 

Leiomyosarcoma is believed to originate in the body’s smooth muscles, including the uterus, the intestines, stomach, bladder and blood vessels. Since smooth muscle is present throughout the body, leiomyosarcoma  can occur anywhere in the body.

To learn more about this form of soft tissue sarcoma, we spoke with Patrick Lin, M.D., an orthopaedic surgeon who treats leiomyosarcoma patients in MD Anderson’s Sarcoma and Orthopaedic Center, the nation’s largest program for bone and soft tissue sarcomas.

What is leiomyosarcoma?

Leiomyosarcoma is a rare type of cancer that falls into the category of sarcomas, which generally arise from connective tissue. Leiomyosarcoma generally forms in the smooth muscles of the body.

What are the symptoms of leiomyosarcoma?

The symptoms depend on where the tumor occurs, which can be almost anywhere. Leiomyosarcoma often presents as a firm, painless lump in the soft tissues of the body. It sometimes causes cramping or pain when it arises in an internal organ, such as the uterus or in the digestive tract. Symptoms rarely involve the bones, except in late stages of the disease.

How is leiomyosarcoma diagnosed?

The gold standard for diagnosis is tissue biopsy of the primary tumor. This can be accomplished by needle biopsy. This is when a needle is used to obtain a sample of cells from the tumor for laboratory testing.

What is the prognosis for someone diagnosed with leiomyosarcoma?

The prognosis for leiomyosarcoma varies greatly depending on the stage of disease. Size and metastatic spread are key factors in leiomyosarcoma. We are most likely to be able to successfully treat a patient if the cancer is caught in its early stages.

Where can leiomyosarcoma occur in the body?

The most common location is the uterus, which is composed largely of smooth muscle. But it can occur anywhere, since smooth muscle is present in all blood vessels, as well as part of the intestines and digestive tract.

What are the treatment options for leiomyosarcoma?

Surgery is the mainstay of treatment for leiomyosarcoma, but radiation therapy and chemotherapy are often used in conjunction with surgery. Surgery for leiomyosarcoma also varies greatly, depending upon the location and size of the tumor. But in most cases a surgeon will remove the tumor and a sufficient area of normal tissue surrounding it to ensure all the cancer is removed and doesn’t return. The extent of surgery will determine the length of recovery and need for rehabilitation.

What’s your best advice for someone who has just been diagnosed with leiomyosarcoma?

It’s important to have a consultation with an oncologist who is familiar with the disease. The pathologic diagnosis can be difficult, and sometimes review of the biopsy by an expert pathologist is needed. A complete staging is needed before formulating a treatment plan. Once we have an accurate diagnosis and stage, we can work with the patient to come up with the best treatment plan for them.

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