Introduction/Background Leiomyosarcomas of the gynecological tract (LMS) are heterogeneous group of mesenchymal gynecological cancers with unspecific but dismal prognosis since they generally spread even in early stages.

Methodology We conducted a retrospective study of all female with LMS treated at our institution during the previous 22 years. Clinicopathological information, therapies, and results were all documented.

Results Data were collected from 16 women. The median age at diagnosis was 51 years old (31–77 yo). 50% of patients were menopausal. Bleeding was the most common symptom, followed by pelvic discomfort. Ten patients had uterine leiomyosarcoma, three had cervix leiomyosarcoma, and three had vaginal leiomyosarcoma. The average size of the tumor was 6.4 cm (3–10 cm). There were no evidence of distant metastasis in all patients. As an initial treatment, fifteen patients had surgery, while one patient received extemal beam radiation followed by brachytherapy. Adjuvant chemotherapy was administered to four patients, while adjuvant radiation was administered to seven. Six patients were diagnosed with LMS grade 1, three with grade 2, and seven with grade 3. The average duration of follow-up was 61 months. Full remission was obtained in nine cases while five suffered from a progressive disease course and two had locoregional recurrence. Seven patients died.

Conclusion The relative rarity of LMS, as well as its clinical variety, inhibit studies aiming at improving understanding of the disease and makes establishing the best therapy challenging.