Patients with leiomyosarcoma mostly have no symptoms and signs of disease, other than irregular vaginal bleeding or growing mass protruding into vagina. Physical examination findings depends upon the site of the involvement, size of tumor and metastasis. Physical examination findings may include weight loss, abdominal mass, abdominal distension, vaginal bleeding or discharge.

Physical examination findings depends upon the site of the involvement,size and metastasis.^{[1][2][3][4][5][6][7]}

• Patients with leiomyosarcoma are generally weak due to weight loss.

• Low grade fever

• Jaundice may appear if the tumor develops in the inferior vena cava in the supra-hepatic segment or metastasis to pancreas.

• Pallor

• Lymphadenopathy

• Dyspnea and chest pain in case of leiomyosarcoma of the pulmonary artery.

• Non tender abdominal mass
• Abdominal distension, hepatomegaly and ascites in case of leiomyosarcoma of the inferior vena cava.

• Blood on rectal examination.

• Vaginal bleeding and discharge in case of uterine leiomyosarcoma.

• Lower extremity edema if the tumors that arise in the inferior vena cava below the liver.

• Paresthesia due to the compression of the neurovascular bundle by the enlarging mass

• Rarely, leiomyosarcoma presents with paraneoplastic hypoglycemia, which is usually secondary to the tumour production of insulin like growth factor-2

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