Uterine leiomyomas are highly prevalent, representing around 70-80% of  uterine neoplasms, they are hormonally dependent and usually involute after menopause. In contrast, leiomyosarcomas represent less than 1%, and a new or growth postmenopausal mass supports suspicion. Furthermore, the prevalence of malignancy increases when there are symptoms, such as abnormal uterine bleeding, abdominal distension, pelvic pain or urinary symptoms, however this does not confirm the diagnosis. Clinical and therapeutic strategies are dictated by the location, using FIGO classification and MRI signal, and enhancement pattern.