Uterine sarcoma is a type of cancer that affects the muscle and tissues that support the uterus or womb (connective tissue).
Sarcomas are cancers that originate from tissues such as muscles, fat, bones, and fibrous tissue (the material that makes tendons and ligaments). Cancers that start in the epithelial cells, which line most of the organs, are called carcinomas.
Most cancers of the uterus are carcinomas (more than 95%). If a carcinoma begins in the cervix, it is called cervical carcinoma. Carcinomas that start in the endometrium, the uterine lining, are called endometrial carcinomas.
Most uterine sarcomas are classified into 1 of 3 categories, depending on the type of cell from which they originated.
-Endometrial Stromal Sarcomas as the name suggests develop in the connective tissues of the endometrium. This type of cancer is extremely rare and constitutes barely 1% of all cases of uterine cancers. Tumors which grow in this type of cancer progress very slowly if at all and the cancers cell do not look abnormal when seen under a microscope.
Patients with these tumors have a better prognosis than those with other uterine sarcomas.
-Undifferentiated Sarcomas were considered a type of endometrial stromal sarcoma, but because they are more aggressive and treated differently compared to low-grade tumors. These form of cancers are rare and do not occur in more than 1% of all cases but tend to have an extremely guarded prognosis.
-Uterine Leiomyosarcomas develop within the myometrium which is a muscular wall surrounding the uterus. Such tumor are also rare and are seen in approximately 2% of all cases of uterine cancers.
Another type of cancer that begins in the uterus is called carcinosarcoma. These cancers originate in the endometrium and have characteristics of both sarcomas and carcinomas. They can be classified with uterine sarcomas, although many healthcare professionals now think they are more closely related to carcinomas. These cancers are also known as malignant mixed Müllerian tumors.
What are The Symptoms of Leiomyosarcoma?
The most frequent symptom of the Leiomyosarcoma is vaginal bleeding even after attaining menopause or bleeding which is not a part of the normal menstrual cycle of reproductive females. However, in majority of cases such bleeding is not due to cancer even though this forms a part of the symptom complex for uterine cancer. Other symptoms may be vaginal discharge, a lump in the vagina or uterus.
-Bleeding or Abnormal Spotting. If the patient has already experienced menopause, any vaginal or spotting is abnormal, and it requires urgent medical attention.
Approximately 90% of patients diagnosed with leiomyosarcoma tend to complain of irregular vaginal bleeding in between their normal menstrual cycle or they continue to have irregular bleeding even after attaining menopause. This symptom in most cases is not cancer induced; however, it is extremely vital to get a thorough evaluation if any irregular bleeding occurs. Of uterine sarcomas, leiomyosarcomas have comparatively less likelihood of causing abnormal bleeding to undifferentiated sarcomas and endometrial stromal sarcoma.
-Vaginal Discharge. Approximately 10% of women with leiomyosarcoma have a vaginal discharge that has no apparent blood. A discharge more likely signals an indwelling infection or an underlying medical condition but it also is a clear symptom of cancer and any such complaints of discharge should be thoroughly investigated by the physician.
-Pain or Pelvic Mass. At the time of initial diagnosis, about 10% of women with leiomyosarcoma have pelvic pain and/or a mass (tumor) that can be palpated. It is possible that the doctor may feel the mass in the uterus, or even the patient can experience “fullness” in the pelvis.
Consultation with a Specialist
If there is a suspicion of a uterine cancer, then the standard recommendations of most physicians is a comprehensive examination by a gynecologist or an oncologist specializing in gynecology (a doctor who specializes in the diagnosis and treatment of cancers of the female reproductive system).
Complete Medical History and Physical Examination
The doctor will ask about family and personal medical history. The patient will also be asked about the leiomyosarcoma symptoms, risk factors and any other health issues. The woman will have a general physical examination and a pelvic exam as a general rule.
The four options for the treatment of uterine sarcoma are surgery, radiation therapy, chemotherapy and hormone therapy.