Leiomyosarcoma
Citation, DOI, disclosures and article data
At the time the article was created Yuranga Weerakkody had no recorded disclosures.
View Yuranga Weerakkody's current disclosuresAt the time the article was last revised Arlene Campos had no financial relationships to ineligible companies to disclose.
View Arlene Campos's current disclosures- Leiomyosarcoma (LMS)
- Leiomyosarcomata
- Leiomyosarcomas
Leiomyosarcomas are extremely rare malignant neoplasms that originate from smooth muscle cells and may be considered the malignant counterpart of a leiomyoma. They are classified as soft-tissue tumors and account for approximately 8% of malignant soft-tissue tumors 10.
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Pathology
Location
Leiomyosarcomas can potentially occur anywhere there is smooth muscle. Commonly described sites include the following:
uterus: uterine leiomyosarcoma: most common, (accounting for up to one-third of uterine sarcomas 8)
retroperitoneum: retroperitoneal leiomyosarcoma; most common non-uterine site 11
stomach 1: gastric leiomyosarcoma
esophagus 5: esophageal leiomyosarcoma
small intestine: leiomyosarcoma of the small intestine
liver: hepatic leiomyosarcoma
bladder
nasopharynx
bone 6: primary leiomyosarcoma of bone
-
venous structures 10
central nervous system: primary intracranial leiomyosarcoma
Other sites include:
pulmonary artery: primary pulmonary artery leiomyosarcoma
skin: cutaneous leiomyosarcoma 13
Radiographic features
Morphological imaging features would be invariably dependent on the site (refer to individual articles). Generally, they tend to be large masses, especially in cases of abdominopelvic lesions.
CT
generally heterogeneous
commonly demonstrate central low attenuation representing necrosis 12
calcification exceedingly rare
MRI
The tumor frequently demonstrates cystic foci. Signal characteristics include:
T1: isointense to muscle
T2 non-fat suppressed: intermediate to hypointense to neighboring fat
T2 FS: predominantly hyperintense
Differential diagnosis
For a meaningful differential, it is necessary to consider site-specific tumors.
References
- 1. Disler DG, Chew FS. Gastric leiomyosarcoma. AJR Am J Roentgenol. 1992;159 (1): 58. AJR Am J Roentgenol (citation) - Pubmed citation
- 2. Bush CH, Reith JD, Spanier SS. Mineralization in musculoskeletal leiomyosarcoma: radiologic-pathologic correlation. AJR Am J Roentgenol. 2003;180 (1): 109-13. AJR Am J Roentgenol (full text) - Pubmed citation
- 3. Rha SE, Byun JY, Jung SE et-al. CT and MRI of uterine sarcomas and their mimickers. AJR Am J Roentgenol. 2003;181 (5): 1369-74. AJR Am J Roentgenol (full text) - Pubmed citation
- 4. Kaushik S, Neifeld JP. Leiomyosarcoma of the renal vein: imaging and surgical reconstruction. AJR Am J Roentgenol. 2002;179 (1): 276-7. AJR Am J Roentgenol (full text) - Pubmed citation
- 5. Levine MS, Buck JL, Pantongrag-brown L et-al. Leiomyosarcoma of the esophagus: radiographic findings in 10 patients. AJR Am J Roentgenol. 1996;167 (1): 27-32. AJR Am J Roentgenol (abstract) - Pubmed citation
- 6. Bush CH, Reith JD, Spanier SS. Mineralization in musculoskeletal leiomyosarcoma: radiologic-pathologic correlation. AJR Am J Roentgenol. 2003;180 (1): 109-13. AJR Am J Roentgenol (full text) - Pubmed citation
- 7. Davies CE, Davies AM, Kindblom LG et-al. Soft tissue tumors with muscle differentiation. Semin Musculoskelet Radiol. 2010;14 (2): 245-56. doi:10.1055/s-0030-1253165 - Pubmed citation
- 8. Rha SE, Byun JY, Jung SE et-al. CT and MRI of uterine sarcomas and their mimickers. AJR Am J Roentgenol. 2003;181 (5): 1369-74. AJR Am J Roentgenol (full text) - Pubmed citation
- 9. Matsuyama A, Hisaoka M, Hashimoto H. Vascular Leiomyosarcoma: Clinicopathology and Immunohistochemistry with Special Reference to a Unique Smooth Muscle Phenotype. Pathol Int. 2010;60(3):212-6. doi:10.1111/j.1440-1827.2009.02508.x - Pubmed
- 10 .Kransdorf MJ. Malignant soft-tissue tumors in a large referral population: distribution of diagnoses by age, sex, and location. AJR Am J Roentgenol. 1995;164 (1): 129-34. AJR Am J Roentgenol (abstract) - Pubmed citation
- 11. O'Sullivan P, Harris A, Munk P. Radiological Imaging Features of Non-Uterine Leiomyosarcoma. Br J Radiol. 2008;81(961):73-81. doi:10.1259/bjr/18595145 - Pubmed
- 12. McLeod A, Zornoza J, Shirkhoda A. Leiomyosarcoma: Computed Tomographic Findings. Radiology. 1984;152(1):133-6. doi:10.1148/radiology.152.1.6729102 - Pubmed
- 13. Juan Y, Saboo S, Tirumani S et al. Malignant Skin and Subcutaneous Neoplasms in Adults: Multimodality Imaging with CT, MRI, and 18F-FDG PET/CT. AJR Am J Roentgenol. 2014;202(5):W422-38. doi:10.2214/AJR.13.11424 - Pubmed
Incoming Links
- WHO classification of tumours of the breast
- Primary intracranial leiomyosarcoma
- Small bowel lymphoma
- WHO classification of tumours of bone
- Dedifferentiated chondrosarcoma
- Tracheal masses
- Hypervascular metastases
- Skin cancer
- Hypervascular liver lesions
- Deep fibrous histiocytoma
- Urinary bladder wall or lumen calcification (differential)
- Broad ligament
- Embryonal rhabdomyosarcoma
- Parasitic leiomyoma
- Unilateral hypertransradiant hemithorax
- Tumours of the small intestine
- Oesophageal leiomyosarcoma
- Soft tissue sarcoma
- Inferior vena cava leiomyosarcoma
- Leiomyoma
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