Uterine growths can be a source of concern, as their symptoms may resemble those of more serious conditions like cancer. This article clarifies the distinctions between common benign uterine growths and rare malignant ones, providing insight into how medical professionals differentiate between these conditions.
Understanding Common Uterine Growths
Uterine fibroids, medically known as leiomyomas, are non-cancerous growths that develop from the muscle and fibrous tissue of the uterus. These growths are exceedingly common, affecting a large percentage of women during their reproductive years, with estimates suggesting up to 77% of women may develop them by age 50. Fibroids can vary widely in size, from microscopic to large enough to fill the entire uterus, and can grow in different locations within or on the uterine wall.
In contrast, uterine leiomyosarcoma is a rare but aggressive form of uterine cancer that originates in the smooth muscle cells of the uterus. While fibroids are benign, leiomyosarcomas are malignant, meaning they can grow quickly and spread to other parts of the body. This type of cancer is considerably less common than fibroids, accounting for a small fraction, around 2% to 5%, of all uterine malignancies. The average age of diagnosis for uterine leiomyosarcoma is typically around 51, often in the perimenopausal years.
Overlapping Symptoms and Distinguishing Clues
Both uterine fibroids and leiomyosarcomas can present with similar symptoms. Common signs include abnormal uterine bleeding, such as heavy or prolonged periods, and bleeding between periods. Individuals may also experience pelvic pain or pressure, a feeling of fullness in the lower abdomen, frequent urination, constipation, or increased abdominal size. Pain during intercourse is another symptom associated with both conditions.
Despite these overlaps, certain “red flags” might suggest the presence of a leiomyosarcoma. A rapid increase in the size of a presumed fibroid, particularly after menopause, is a significant concern. New onset of vaginal bleeding after menopause should always be investigated, as it is a common symptom of uterine cancer. Persistent or worsening pelvic pain, unexplained weight loss, fever, or unusual vaginal discharge are also potential indicators that warrant immediate medical evaluation. Symptoms alone are not definitive for diagnosis; medical assessment is necessary to determine the underlying cause.
Diagnostic Approaches for Clarification
Differentiating between fibroids and leiomyosarcoma involves a careful medical evaluation, often beginning with a pelvic exam where a healthcare provider may feel a uterine mass. Imaging studies are usually the next step. An ultrasound, including transvaginal and abdominal approaches, is frequently the initial imaging technique.
Magnetic Resonance Imaging (MRI) offers more detailed images and can help assess characteristics that might suggest malignancy, such as blood flow patterns, though it cannot definitively distinguish between a benign fibroid and a leiomyosarcoma. For a definitive diagnosis of uterine leiomyosarcoma, tissue examination through pathology is necessary. This typically requires surgical removal of the mass, either through a myomectomy (removal of fibroids) or hysterectomy (removal of the uterus), followed by microscopic analysis of the tissue.
Pre-operative biopsy of a suspected leiomyosarcoma within the uterine wall is often not feasible or reliable due to the tumor’s location and the potential for sampling error. Therefore, many uterine leiomyosarcomas are incidentally diagnosed after surgery for what was presumed to be a benign fibroid. While blood tests are not diagnostic for these conditions, they may be used to rule out other medical issues.
When to Consult a Healthcare Professional
It is important to seek medical attention for any new, worsening, or concerning symptoms related to uterine health. Consult a healthcare professional if you experience changes in menstrual bleeding patterns, such as unusually heavy or prolonged periods, or bleeding between periods. Vaginal bleeding after menopause is particularly important and should always prompt an immediate medical evaluation.
A rapid growth of a known uterine mass or the development of new pelvic pain, especially if persistent or severe, also warrants professional assessment. Unexplained weight loss or persistent fatigue in conjunction with uterine symptoms should also be discussed with a doctor.