Editing Soft tissue sarcoma (section)

=== '''Leiomyosarcoma''' ===

** Malignant smooth muscle tumour
** Can originate from virtually any body part - most commonly retroperitoneum, peritoneal cavity (uterus); 25% arise from trunk and extremities
** Peak incidence 50-70yo
** Risk factors - radiation, immunosuppression, EBV-related tumour promotion. Does not arise from a degenerated leiomyoma.
** Heterogeneous, well-circumscribed tumour with an often cystic or necrotic central area
** Stains positive for desmin and smooth muscle actin (see table on 'GIST' page). Wide variety of cytopathologic aberrations but no reliable or pathognomic markers
** Treatment
*** First-line: resection with negative margins
**** Uterus - total hysterectomy and bilateral oophorectomy
*** Adjuvant therapy not currently recommended. Mets usually haematogenous, mainly lung and liver.