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Am I at risk for uterine cancer?

Posted by Dr. Lyndon Taylor on Feb 22, 2018 9:00:00 AM

What is uterine leiomyosarcoma?

shutterstock_569744245.jpgUterine leiomyosarcoma is a rare type of uterine cancer. It is the most common type of uterine malignancy making up roughly 3-7% of all uterine cancers and makes up less than 1% of all gynecologic malignancies [1]. It is nearly impossible to differentiate sarcoma from a simple myoma or fibroid from an ultrasound and often is not recognized unless histopathology is done after resection. The risk of leiomyosarcoma increases in women older than 50 years old and fibroids larger than 8 cm [2].

 

If you have been diagnosed with uterine fibroids, be wary of continued fibroid growth of bleeding after menopause as it can be worrisome and warrants further evaluation for possible sarcoma. Leiomyosarcomas present almost identically to uterine fibroids, however, a key difference is fibroids will typically shrink after menopause [3].

Listed below are symptoms associated with uterine leiomyosarcomas:

  • Abnormally heavy or prolonged bleeding or spotting
  • Post-menopausal bleeding
  • Pelvic pain or pressure
  • Pelvic mass
  • Bladder problems including frequent urination
  • Pain in lower back

Leiomyosarcomas can easily be mistaken for fibroids on ultrasound examination. However, other imaging scans can also be used to evaluate such as CT scan, MRI, or a PET scan. Unfortunately, it is still extremely difficult to diagnose without a biopsy or histopathology after removal. On histopathology, leiomyosarcomas present as less well-circumscribed in comparison to fibroids. Historically, large fibroids were treated by morcellation, a device with a spinning blade that cut up the mass to make it easier to take out through laparoscopic surgery. However, it was discovered, if a sarcoma was mistakenly diagnosed as a fibroid and morcellated, there was a risk of spreading the cancer cells throughout the pelvic and abdominal cavity and thus, it was discontinued [4]. This can be a scary thought because one study estimated nearly half of all uterine leiomyosarcomas are not diagnosed until after surgical removal. This type of cancer is very aggressive and is typically resistant to our current regimens of chemotherapy and radiotherapy [5]. The recommended treatment is laparotomy or a total hysterectomy [2].En bloc removal of the uterus is the safest measure to treat uterine sarcomas.

 

For women suffering from fibroids or think you might have a sarcoma

If you are suffering from uterine fibroids and are worried you may have a sarcoma or it runs in your family, Dr. Lyndon Taylor and his team are the experts you’ve been searching for. If you’re ready to live a better and healthier life, free from worry, call 708-848-9440 for more information.

 

Ready to get started? Schedule a free second opinion consultation today!

 

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References

 

  1. Benson, C. and A.B. Miah, Uterine sarcoma - current perspectives. Int J Womens Health, 2017. 9: p. 597-606.
  2. Tanos, V. and K.E. Berry, Benign and malignant pathology of the uterus. Best Pract Res Clin Obstet Gynaecol, 2017.
  3. D'Angelo, E. and J. Prat, Uterine sarcomas: a review. Gynecol Oncol, 2010. 116(1): p. 131-9.
  4. Skorstad, M., A. Kent, and M. Lieng, Uterine leiomyosarcoma - incidence, treatment, and the impact of morcellation. A nationwide cohort study. Acta Obstet Gynecol Scand, 2016. 95(9): p. 984-90.
  5. Ricci, S., R.L. Stone, and A.N. Fader, Uterine leiomyosarcoma: Epidemiology, contemporary treatment strategies and the impact of uterine morcellation. Gynecol Oncol, 2017. 145(1): p. 208-216.

Topics: help with fibroids, fibroids second opinion

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