Leiomyosarcomas may rarely occur within benign fibroid tumors. Chemotherapy with docetaxel/gemcitabine, ifosfamide/doxorubin, and trabectedin can have palliative effects. Gestational trophoblastic malignancy is curable with single agent (if localized; methotrexate or actinomycin D) or combination chemotherapy (if widely metastatic; EMA-CO, etoposide, methotrexate, and actinomycin D alternating with cyclophosphamide and vincristine).