Leiomyosarcoma

Last revised by Dr MT Niknejad on 28 Sep 2021

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.

Leiomyosarcomas can potentially occur anywhere where there is smooth muscle. Commonly described sites include the following:

Other sites include

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.

  • generally heterogeneous
  • commonly demonstrate central low attenuation representing necrosis 12
  • calcification exceedingly rare

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 

For a meaningful differential, it is necessary to consider site-specific tumors.

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Cases and figures

  • Case 1: uterine leiomyosarcoma
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  • Case 2: uterine leiomyosarcoma
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  • Case 3: of small bowel
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  • Case 4 : lung metastases from a leiomyosarcoma
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  • Case 5: uterine leiomyosarcoma
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