Leiomyosarcoma
Last revised by Dr MT Niknejad ◉ on 28 Sep 2021
Citation, DOI & article data
Citation:
Weerakkody, Y., Niknejad, M. Leiomyosarcoma. Reference article, Radiopaedia.org. (accessed on 08 Aug 2022) https://doi.org/10.53347/rID-10870
Permalink:
rID:
10870
Article created:
28 Sep 2010 by Dr Yuranga Weerakkody ◉
Revisions:
28 times by 12 users - see full revision history
Systems:
Sections:
-
Synonyms:
- Leiomyosarcomas
- Leiomyosarcoma (LMS)
- Leiomyosarcomata
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 a soft tissue tumor and account for ~8% of malignant soft tissue tumors 10.
On this page:
Pathology
Location
Leiomyosarcomas can potentially occur anywhere where there is smooth muscle. Commonly described sites include the following:
- uterus: uterine leiomyosarcoma: most common (account 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
- spermatic cord: spermatic cord leiomyosarcoma
- pulmonary artery: primary pulmonary artery leiomyosarcoma
Radiographic features
Morphological imaging features would be invariably dependent on the site (refer to individual articles). Generally, they tend to be large masses, especially with 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 citation
- 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 PJ, Harris AC, Munk PL. Radiological imaging features of non-uterine leiomyosarcoma. Br J Radiol. 2008;81 (961): 73-81. doi:10.1259/bjr/18595145 - Pubmed citation
- 12. Mcleod AJ, Zornoza J, Shirkhoda A. Leiomyosarcoma: computed tomographic findings. Radiology. 1984;152 (1): 133-6. Radiology (abstract) - Pubmed citation
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