How Rare is Leiomyosarcoma?

Uterine sarcoma has a world-wide relative incidence of 0.5 to 3.3 cases per 100,000 women , Müllerin mix tumors of 0.82 per 100,000 women , Leiomyosarcoma have an relative incidence of 0.64 per 100,000 women . Sarcomas of the endometrial stroma report an incidence of 0.19 per 100,000 woman . They represent globally 3 % to 4 % of uterine tumors . There are few epidemiological studies to identify the risk of infection factors . It is know that its display with greater frequency is in women of 40 to 60 years of age , the antecedent of intake of oral contraceptives and estrogen antagonist .

space-reflection symmetry , menarche andmenopauseare not conclusive . The history of pelvic radiation therapy represents a hazard of 5 % to 10 % . accord to the backwash , it is two to three times higher its relative incidence in African Americans .

Sarcomas of the uterus typify a diverse chemical group of tumor , constituting only 1 % of the malignant neoplasms of the female genital tract and occupy 3 to 8.4 % of malignant uterine neoplasms . The watch are the types of uterine sarcoma :

Leiomyosarcoma

Leiomyosarcoma is the most frequent type of uterine sarcoma . It presents itself as a pelvic mass in 54 % of cases , bleeding vagina in 56 % and in 22 % withpelvic infliction .

From the histological head of scene , they must be differentiated from atypical leiomyomas or from leiomyoma with mitotic activeness . The tumoral necrosis is the key point in the diagnosing and must be differentiated of hyalinization and ulcerative sphacelus .

Endometrial Stromal Sarcoma (ESS)

It represents 10 to 15 % of sarcoma and 0.2 % of all uterine tumors . It occur more frequently between 40 and 55 years of age , transvaginal bleeding is the most common sign , although 25 % are asymptomatic .

Pleomorphic Sarcoma

Also be intimate as Sarcoma of the undifferentiated endometrial stroma , it has the characteristic of being a very mellow - gradation neoplasm with a poor prognosis . It may or may not show transition with area of low - grade endometrial stromal sarcoma and recently it has been subdivided into two category depending on the cytological atypia in : a ) sarcoma of the high - grade endometrial stromal a and b ) undifferentiated sarcoma .

Immunohistochemistry study are not useful for the diagnosis of neoplasia and it is considered an exception diagnosing after having ruled out other uterine neoplasm .

Other less frequent uterine sarcomas are the adenosarcomas , rhabdosarcoma and pecomas .

Symptomatology

The principal symptom is transvaginal bleeding ( 95 % ) . It is characterized by a fluctuating amount ; it can be attach to by pain , malodour or symptom of pelvic pressure .

Patients have different level ofanemia . In the physical examination the doctors can chance womb increased in sizing . The main differential diagnosis of sarcoma is leiomyoma .

There is no screening method for these neoplasms . In general , the clinical datum that paint a picture the mien of a uterine sarcoma , independently of the histological lineage , are a voluminous uterine tumor of rapid growth , transvaginal bleeding and pelvic pain .

From an image distributor point of view , the diagnosis can be a problem especially in untried fair sex , since the suspicion of malignancy is not uncouth because the gynecological revision are tie in to menstrual irregularities and unnatural venereal haemorrhage .

The discourse of choice in uterine sarcomas is “ optimum ” surgical process : in leiomyosarcomas , entire hysterectomy ( surgical origin of the uterus ) , double adnexectomy and pelvic lymphadenectomy ( operative descent of the lymph nodes ) , if they are dilate . Regarding the accessory treatment , patients with stage I and II , radiation increase local control , but does not seem to strike overall survival . likewise , chemotherapy fall the bed high proportionality of subclinical tumour dissemination , but there has been no melioration in overall survival either . In inoperable patients , with a recidivate or recurrent disease , the therapeutic alternative are radiotherapy and palliativechemotherapy . In the differential diagnosis of fast - mature abdominal masses , uterine sarcoma should be a possibility to be taken into account .

Conclusion

Uterine sarcomas are rare tumors , which represent up to 4 % of uterine tumour . Its prognosis is poor and there are few prospective studies of its intervention and clinical responses . Uterine sarcomas have a reserved forecast , with favorable treatment rates with surgery . The role of auxiliary treatment is not intelligibly present .