Leiomyosarcoma (LMS) is a form of cancer that can be very difficult to detect, which is unfortunate since the best prognoses come from treating it at its earliest stages. The difficulty in detecting it is due to the simple fact that patients do not always experience any noticeable symptoms. While some swelling or a lump beneath the skin may be the first indication of disease, this can occur at a much later stage of the disease. Additionally, LMS is cancer of the soft tissue and involuntary muscle, meaning it can appear anywhere, including deep inside of the body.
When it is diagnosed, one of the first things done is to grade and then stage it. This requires the use of a biopsy or sample of the tissue, and is done specifically to determine if the cancer has spread within the tissue, or even to other parts of the body.
How is it Done?
Staging is done using a few processes, and it requires a thorough diagnosis to do properly. This is because it uses the biopsy along with the imagery of the tumor(s) to determine location and size. It is meant to grade and size the tumor, determine if it is superficial or deep, and to recognize if it has spread or metastasized elsewhere in the body.
It begins with the biopsy and collection of cells. These are put under a microscope and an expert pathologist will determine if the cells appear similar to that of the soft tissue from which they were taken or if they are abnormal in appearance. Should the cells seem very much like their tissue of origin, the LMS is graded as low-grade. If they are abnormal, indicating they are likely to grow quickly and spread, they are called high-grade or poorly differentiated.
A high-grade tumor is one that shows a need for immediate action. Regardless of the grade, there is also the need to properly size the tumor, and this will be done through the use of an array of imaging devices (based on the organ or tissue affected by LMS). It can be a CT scan, MRI, or PET scan used to determine the size and location of the tumor.
After this, the team knows the grade and the size as well as whether or not it is superficial or deep, and then the biopsy is done along with a complete blood count and any other blood chemistry tests deemed necessary. When done, the information will help the team to properly stage the tumor and determine the best course of action and the most likely prognosis for the patient.
The Stages of Leiomyosarcoma
Staging LMS means looking at the size of the tumor done during diagnosis, and looking to see if or how far it has spread beyond the original location. The most commonly used scale of stages is known as the AJCC system and it uses the grade, the size, the location, and signs of metastatic activity.
The staging uses a very simple alpha-numeric designation of mildest to most severe stages, and looks like this:
- 1A – low grade/less than 5cm in size/can be superficial or deep/no metastatic disease
- 1B – low grade/more or less than 5 cm in size/superficial/no metastatic disease
- 2A – low grade/more or less than 5 cm in size/deep/no metastatic disease
- 2B – high grade/less than 5 cm in size/can be superficial or deep/no metastatic disease
- 2C – high grade/more or less than 5 cm in size/superficial/no metastatic disease
- 3 – high grade/more or less than 5 cm in size/deep/no metastatic disease
- 4 – any grade/any size/any location/metastatic disease
With this system, a medical team can then design the most appropriate treatment and give their patient the most accurate prognosis. This sort of diagnosis is vital to combating LMS, and is the best step towards overcoming it.
SacromaHelp.org. Leiomyosarcoma Cancer. 2015. http://sarcomahelp.org/leiomyosarcoma.html#tpm1_1