Misdiagnosis and Leiomyosarcoma
If there is one form of cancer that can be very accurately labeled as occult, it would be Leiomyosarcoma (LMS). A cancer of the soft tissue and involuntary muscles, it can remain hidden for long periods of time. In fact, in one study done of uterine LMS, it was only one out of six cases that were diagnosed properly in the preoperative period.
Why is it challenging to properly diagnose LMS? Quite simply, though there are many imaging techniques used and even biopsies, it is still possible for other medical conditions to be considered before LMS is targeted as the prime candidate.
Examples of Leiomyosarcoma Misdiagnosis
As a simple example, a woman may have a history of fibroid tumors and gynecological problems. This may then conceal the development of LMS in the uterine wall, and imaging may fail to indicate that it is a local tumor in the smooth tissue and involuntary muscle rather than the organ itself.
Because LMS can appear anywhere in the body, due to its ability to grow in any blood vessel, it can easily confuse or mislead even the most effective diagnosticians. One medical group indicates that the other diseases commonly diagnosed or confused with LMS include:
- Endometrial cancer
- Small intestine cancer
- Stomach cancer
- Uterine fibroids
Of course, there are also many undiagnosed conditions that can lead to a misdiagnosis of LMS, as well, or confuse matters due to similar symptoms. For instance, the following female reproductive problems and conditions are often undiagnosed and discovered when LMS is suspected:
- Overactive bladder syndrome
- Polycystic ovary syndrome
- Pelvic inflammatory disease
- Breast cancer
- Ovarian cancer
- Cervical cancer
- Von Willebrand disease
- Spitz nevi (a dangerous skin cancer variant)
Obviously, this is not the full list, and there are many other ways that a misdiagnosis may occur, and that LMS is not discovered quickly or mistaken for another condition.
The Faces of LMS
Because of the very nature of LMS, and its ability to appear in any part of the body, it is not always easy to properly diagnose. It is commonly found in the uterus, the trunk of the body (especially the stomach, small intestine, and the retroperitoneum or abdominal cavity), and the limbs. It does also appear in the skin, but here it can be more easily diagnosed because it tends to strike only the pilo-erector muscles.
In recent years, the medical field has distinguished gastrointestinal stromal tumors, now known as GIST, from the rest of the LMS conditions. This is due to the identification of the genetic markers that cause the tumors, and the aggressive treatments created to manage the condition.
Keep in mind that the tests done to determine any medical condition depend entirely on the organ or area of the body in which you have a medical complaint. Thus, a direct and straightforward diagnosis of LMS may not be a possibility. Instead, it may be that you have an ultrasound, CT scan, MRI, and biopsy before the issue LMS arises or is dismissed.
The biopsy is often ordered as a result of other tests and diagnoses, and is usually the last step taken once cancer is suspected. At that point, the biopsy indicates cancer and sarcoma, and may not yet point to LMS. It takes the skill of an experienced pathologist working with your oncologist to properly understand the condition, and to then grade and stage the condition.
It is not impossible, even in the modern era, for qualified medical experts to overlook LMS or to misdiagnose you with another condition. You are your own best advocate at any point, and it is best to find out all that you can when a soft tissue sarcoma has been discovered, and to then make certain that the fullest diagnosis has been done.
RightDiagnosis.com. Misdiagnosis of Leiomyosarcoma. 2015. http://www.rightdiagnosis.com/l/leiomyosarcoma/misdiag.htm
JPMA.org. Leiomyosarcomas: Analysis of Clinical Presentations. http://www.jpma.org.pk/full_article_text.php?article_id=2378