Your doctor can easily diagnose some health problems by sight or touch. But you will need to have certain tests done to find out if you have leiomyosarcoma. Because leiomyosarcomas are rare, your doctor may refer you to a medical center that has doctors who have diagnosed or treated many people who have this type of cancer.
Your doctor may want you to have one or more of these tests.
An imaging test takes a picture of the inside of your body. A doctor, radiation technologist, or other health professional will take the pictures during the test.
If your doctor is at a large medical center, you may be referred to the center’s radiology or nuclear medicine department. The test can also be done at a hospital, a doctor’s office, or an imaging center or clinic. A radiologist, a doctor who is an expert in reading imaging tests, will report the results to you and your doctor.
The imaging tests used to look for a leiomyosarcoma are:
X-rays. This method uses a small amount of radiation to take a picture of an area of your body. An X-ray technologist will take the pictures. You will sit, stand, or lie down while the X-rays are taken. The process takes only a few minutes.
Computerized tomography (CT or CAT) scans. The CT machine takes many images from different angles. A computer puts all of the images together to create a picture of the inside of your body.
To get a clearer picture, you may get a contrast dye given as a liquid, put into a vein, or as an enema. Tell your doctor if you are allergic to iodine or seafood or have had a reaction to a contrast dye. This will help your doctor know if the dye is safe for you to get. During the scan, you will lie on a table that will slide back and forth inside a large machine. The scan will take 10 to 30 minutes.
Magnetic resonance imaging (MRI). This method uses strong magnets to create a picture of the soft tissues inside your body. You will lie on a table that slides into a tube inside a big machine that can create a magnetic field.
Before the MRI, you may get a contrast dye called gadolinium to get a clearer picture. This isn’t the same contrast dye used for CT scans. Tell your doctor if you are allergic to iodine or seafood or have had a reaction to a contrast dye in the past. Also let your doctor know if it is hard for you be in small or enclosed spaces.
The MRI machine makes loud noises while it takes pictures. The technologist may give you earplugs or headphones with music to help block out the sounds. The test usually takes 20 to 60 minutes, but it can take longer.
Position emission tomography (PET) scans. This is a type of nuclear scan. Your doctor will give you a tracer through an IV that releases small amounts of radiation as it moves through your body. A cancer will often absorb more or less of the tracer than normal tissue. This will create a spot the radiologist can see in the picture.
During the PET scan, you will lie on a table that will move back and forth through a hole in a large scanner. The process usually takes 30 to 60 minutes.
Ultrasound (sonogram). This test uses sound waves to create a picture of your organs, blood flow, and blood vessels. It can help doctors see tumors that start in soft tissues. These tumors are often harder for a doctor to see on an X-ray. The sound waves are sent out from a wand that the doctor moves over the skin near the growth or lump. Your doctor may need to use a special type of wand that can be inserted into your esophagus (the tube that connects your throat to your stomach), rectum, or vagina to image the growth.
A biopsy removes cells from a growth or lump. A pathologist, a doctor who studies disease in tissues and body fluids, will examine the cells to see if you have a leiomyosarcoma. You may have one or more of these types of biopsies:
Fine needle aspiration. For this biopsy, your doctor will use a thin needle attached to a syringe to take out a small piece of tissue from the growth or lump. Your doctor may use a CT scan to help them see the growth if they can’t easily feel where it is.
Core needle biopsy. Your doctor will numb the area around the growth or lump. Then, your doctor will use a needle to remove a small piece of tissue. The needle is about the size of the ones used to draw blood from a vein. Your doctor may need to take a few samples to be sure there is enough tissue to test.
Surgical biopsy. Your doctor will remove the entire growth or a piece of it during surgery. If the growth is near the surface of your skin, your doctor may only need to numb the area. If the growth is deeper inside your body, you will get general anesthesia and be asleep during the biopsy. Choose a surgeon who has a lot of experience treating people who have sarcomas.
If the test results show that you have leiomyosarcoma, you will need to meet with a cancer specialist to discuss your treatment options.