Uterine Leiomyosarcoma (LMS)

Definition - What does Uterine Leiomyosarcoma (LMS) mean?

Uterine leiomyosarcoma (LMS) is a very rare form of cancer, representing around 8% of all uterine cancers. It is estimated to occur in six out of every one million women in the United States annually. LMS emerges from the smooth muscle lining the walls of the uterus called myometrium. It is an aggressive form of cancer that tends to invade the surrounding tissues rapidly and spreads to distant organs. The average age of onset of LMS is 50 years. This cancer interferes with the reproductive potential of a woman as does its treatment.

FertilitySmarts explains Uterine Leiomyosarcoma (LMS)

The exact cause of a uterine leiomyosarcoma remains obscure. It most often occurs spontaneously. In some instances, radiation in childhood for other cancers like retinoblastoma increases the likelihood of developing uterine leiomyosarcoma in later life survivors. Long-term use of tamoxifen, an anti-breast cancer medication may also account for some cases of uterine sarcoma. Very rarely, LMS may indicate the transformation of a benign (noncancerous) uterine tumor called fibroid. This transformation of fibroid to LMS is, however, controversial.

Women with LMS may develop chronic pelvic pain and heavy vaginal bleeding. However, unfortunately, since the signs or symptoms of LMS are not specific, it is not possible to diagnose LMS before surgery. In women past the menopausal period, rapidly enlarging fibroids, as detected by ultrasound or MRI may hint at the presence of uterine sarcoma instead of the erroneously suspected non-cancerous fibroid.

Similar to some of the giant fibroids, uterine sarcoma can distort the structural framework of the uterus and fallopian tubes. Moreover, this cancer often entails treatments such as surgical removal of the entire uterus ((hysterectomy) along with the ovaries and fallopian tubes (bilateral salpingo-oophorectomy). Surgeons prefer removing the ovaries because the hormones (estrogen and progesterone) produced by them drive the growth of a uterine sarcoma, causing recurrence despite the removal of the tumor and uterus. If the uterine tumor has spread to distant organs, the doctor or oncologist may also offer adjuvant chemotherapy and/or radiation therapy. All these factors have a negative impact on the reproductive outcome of the affected women.

LMS has a poor outcome with a 5-year survival rate of merely 50% in women whose tumor is confined to the uterus.

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