Tuesday, January 15, 2008

How to Treat Leiomyosarcoma


Leiomyosarcoma is a tumor of smooth muscle. It is malignant and its most common location is the gastrointestinal tract. Intestinal leiomyosarcomas probably originate between the muscularis mucosa and muscularis propria layers. A leiomyosarcoma tends to grow outside blood vessels so it frequently does not become an obstruction until later in development. They also tend to bleed when they get larger. The following steps will show how to treat leiomyosarcoma.


Difficulty: Challenging



Step One

Resect the leiomyosarcoma as the only possible cure. Associated lymph nodes should be removed but extensive removal of lymph nodes is not necessary because leiomyosarcomas rarely spread to the lymph nodes.

Step Two

Consult a gastroenterologist to address the extensive gastrointestinal bleeding that leiomyosarcomas typically produce. A biopsy may still be possible if the tumor becomes ulcerated.

Step Three

Determine the grade of the tumor to assess the prognosis by consulting a hematologist or oncologist.

Step Four

Advise the patient that chemotherapy and radiation have only limited benefit in treating leiomyosarcomas. The response rate of these regimens is generally below 40 percent. Imatinib mesylate is the most promising of these and is most effective in increasing the disease-free period after the tumor has been resected.

Step Five

Monitor the patient postoperatively as leiomyosarcomas are likely to recur. Computed Tomography (CT) scans and blood work should be performed regularly with endoscopic examinations, if needed. Chest X-rays also should be taken. Test stool samples for blood and aggressively evaluate abdominal complaints. These screenings are recommended at three, six and twelve months postoperatively and then annually.

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