Possibilities of differential diagnosis of uterine leiomyosarcoma

Uterine leiomyosarcoma is a rare malignant neoplasm consisting of smooth muscle cells, characterized by an aggressive course and poor prognosis. Differential diagnosis of uterine leiomyosarcoma is challenging due to the nonspecificity and low severity of symptoms, particularly in the early stages. Patients with uterine leiomyosarcoma commonly present with complaints in of pelvic pain, abnormal uterine bleeding, and symptoms of compression of nearby organs. The same clinical symptoms are characteristics of patients with uterine leiomyomas. Leiomyosarcoma is often detected after histologic examination of material obtained during surgery for uterine myoma. At the same time, preoperative verification of the malignant nature of the neoplasm is crucial in determining the optimal tactics of surgical treatment. For instance, the use of organ-preserving techniques and morcellation in the treatment of presumed uterine leiomyoma may result in the dissemination of tumor cells and significantly worsen the prognosis in patients with undiagnosed leiomyosarcoma. This review discusses existing methods of preoperative diagnosis of uterine leiomyosarcoma, their efficacy, as well as the possibilities of application in clinical practice.