Uterine leiomyosarcoma: present management

Purpose of review To review current investigations impacting management of uterine leiomyosarcoma (LMS). Recent findings Patients with uterine LMS typically present with vaginal bleeding, pain, and a pelvic mass. Atypical presentations with hypercalcemia or eosinophilia have been reported. Radiographic evaluation with combined positron emission tomography/computed tomography may assist in diagnosis and surveillance in women with uterine LMS. Stage and tumor grade continue to appear to be valid prognostic indicators. A recently developed risk-assessment index is highly predictive of disease-specific survival. Ovarian preservation does not appear to negatively impact outcome. The addition of adjuvant therapy after surgical management does not seem to improve survival. Novel therapies may result from continued improvements in our knowledge of the molecular biology of uterine LMS. Summary Despite the infrequency of uterine LMS, several recent investigations have advanced our understanding of the disease.