Understanding uterine sarcoma and instances of medical negligence

Uterine sarcoma is a rare form of cancer that affects the uterus or its supporting tissues. It is a complicated disease to diagnose, and when not detected early, can have severe consequences. 

In certain instances, it has been observed that medical negligence has led to a delayed diagnosis of uterine sarcoma. This article aims to help you understand uterine sarcoma, the importance of early diagnosis, and how medical negligence can occur in this context.

What is uterine sarcoma?

Uterine sarcoma is a malignant condition where cancerous cells form in the muscles of the uterus or other supporting tissues. This disease is different from endometrial cancer, which originates in the inner lining of the uterus. Uterine sarcoma is a rare kind of cancer that forms in the uterine muscles or the tissues that support the uterus.  There are several subtypes of uterine sarcoma and they are categorized based on the specific type of cells affected.  The main types of uterine sarcoma are:

• Leiomyosarcoma: This is the most common type of uterine sarcoma and it originates in the smooth muscle cells of the uterus. Leiomyosarcomas are often aggressive and tend to spread to other parts of the body.
• Endometrial Stromal Sarcoma (ESS): ESS develops in the connective tissue (stroma) that supports the endometrium, the lining of the uterus.  This type of sarcoma is less common than leiomyosarcoma and generally has a better prognosis.
• Undifferentiated sarcoma: This is a rare and aggressive type of uterine sarcoma where the cancer cells do not resemble normal uterine tissue. It is often diagnosed at an advanced stage and can be challenging to treat.
• Adenosarcoma: Adenosarcoma is a rare form of uterine sarcoma that consists of both malignant (cancerous) and benign (non-cancerous) components.  It typically arises in the lining of the uterus and may have a better prognosis compared to some other uterine sarcomas.

Uterine sarcoma is distinct from the more common uterine cancers, such as endometrial cancer, which arises from the lining of the uterus.  

Risk Factors and Signs

The onset of uterine sarcoma can be influenced by several factors. One of the most significant risk factors includes past treatment with radiation therapy to the pelvis. Furthermore, it has been noted that the use of tamoxifen for breast cancer treatment can also increase the risk of developing uterine sarcoma. A rapidly growing uterine fibroid in a peri-menopausal or postmenopausal woman should raise suspicion of sarcoma.  

Patients with uterine sarcoma may experience:

• Abnormal vaginal bleeding, especially postmenopausal or irregular bleeding between periods.
• Pelvic pain or discomfort: persistent pelvic pain or discomfort may occur, although it is a nonspecific symptom and can be caused by various conditions.
• A feeling of fullness or pressure in the pelvic area: this can occur due to the presence of a tumour affecting the uterus or surrounding tissues.
• Abdominal or pelvic mass: uterine sarcomas can cause the uterus to become larger than usual, leading to a noticeable abdominal or pelvic mass.
• Changes in bowel or bladder habits: in some cases, uterine sarcoma can cause changes in bowel or bladder habits, such as constipation or increased frequency of urination if the tumour presses against nearby organs.
• Painful intercourse
• Backache or leg swelling: in some cases, uterine sarcoma may spread to nearby tissues and organs, causing symptoms such as back pain or leg swelling.

These signs and symptoms, however, can be caused by various other gynecological conditions. Therefore, it is essential to consult a doctor if any such conditions are encountered.

Diagnosis of uterine sarcoma

Diagnosing uterine sarcoma involves several tests and procedures.  A health history check and a general physical and pelvic examination are typically the first steps. 

Other diagnostic tests include a pelvic and transvaginal ultrasound exam, followed by pelvic MRI.  An endometrial or transvaginal biopsy can be attempted.  If the results of an endometrial biopsy are not clear, a Dilatation and curettage (D&C), where tissue samples are removed from the inner lining of the uterus is usually done. A hysteroscopy (a procedure used to examine the vagina, uterus, fallopian tubes, and bladder) can also be helpful. However, diagnosis is often reached after a surgical specimen.  

Stages of uterine sarcoma

Once a diagnosis is confirmed, the stage of the cancer is determined. The stage of the disease is crucial in determining the treatment plan. The stages of uterine sarcoma are:

• Stage I: Cancer is found in the uterus only.
• Stage II: Cancer has spread beyond the uterus but has not spread beyond the pelvis.
• Stage III: Cancer has spread into tissues in the abdomen.
• Stage IV: Cancer has spread beyond the pelvis.

Treatment options for uterine sarcoma

Treatment for uterine sarcoma typically involves surgery, chemotherapy, radiation therapy, and hormone therapy. The treatment plan is usually based on the stage of the cancer, the type and size of the tumour, and the patient's overall health. Patients should consult with a gynaecological oncologist to determine the most appropriate treatment plan for their specific condition.

Medical negligence in uterine sarcoma cases

In certain instances, medical negligence can lead to delayed diagnosis or misdiagnosis of uterine sarcoma. Medical negligence refers to a situation where a healthcare professional provides substandard care, which can lead to harm or injury to the patient.

In the context of uterine sarcoma, medical negligence can involve:

• Failure to carry out appropriate tests.
• Misinterpretation of test results – for example, an ultrasound scan or MRI may be reported to show a fibroid, rather than uterine sarcoma. 
• Failure to refer the patient to a specialist.
• Delay in diagnosis or misdiagnosis.

When medical negligence leads to a delayed diagnosis, the cancer may progress to a more advanced stage, making treatment more challenging and leading to a poorer prognosis.

Legal recourse for medical negligence

Uterine sarcoma is a complex disease that requires prompt and accurate diagnosis for effective treatment. Medical negligence leading to delayed diagnosis can significantly impact the patient's prognosis and quality of life. 

If you believe that you or a loved one has suffered due to medical negligence in the diagnosis or treatment of uterine sarcoma, you may be entitled to make a medical negligence claim. This can help you receive compensation for the physical, emotional, and financial damages you have suffered due to the negligence.

Legal processes can be complex and daunting, so it's crucial to seek expert legal advice. At Tees, our specialist medical negligence solicitors can guide you through the process, helping you gather the necessary evidence and build a strong case.