A rapid increase in size has been thought to be associated with malignancy (sarcoma). Fortunately, this does not seem to be the case. Leiomyosarcoma, the malignancy that sounds similar to fibroids (leiomyomata), is a tumor that does not represent degeneration of a preexisting benign fibroid. These tumors more typically arise in postmenopausal women and are usually associated with a pelvic mass, abnormal bleeding and pelvic pain. Because the symptoms associated with leiomyosarcoma can be quite similar to those of fibroids, they are often mistaken for one another; however, upon diagnosis, it is evident that fibroids are not the cause of cancer.
It is important to state, however, that there is no screening test that can reliably detect this malignancy. The other gynecologic malignancies of concern include cervical, endometrial, and ovarian cancer. Since Uterine Fibroid Embolization (UFE) is a uterine sparing treatment it is important to rule out these diagnoses prior to the procedure. A Pap smear is used to screen for cervical cancer, endometrial biopsy is used for excluding endometrial cancer and other non-fibroid causes of abnormal uterine bleeding, and Ultrasound and MRI are used in evaluating for ovarian cancer. Because fibroids can often block and hide the ovaries and other parts in the uterus, careful examination is necessary before performing UAE.