As the grade of cytopathological result increases, the correlation between biopsy and the smear test also increases. The high sensitivity of the cervical smear test for high-grade lesions shows that it is an effective screening test.

BackgroundUterine smooth muscle tumor of uncertain malignant potential (STUMP) is rare tumor, and regarded as sub-classification in uterine smooth muscle tumors between benign and malignant criteria. In this study, we evaluated characteristics of cases with STUMP diagnosis in a 10-year period.MethodsWe retrospectively evaluated medical records of patients with histopathological STUMP diagnosis in Istanbul Training and Research Hospital, a tertiary center. We analyzed preoperative demographic, clinical features and postoperative follow-up. Preoperative sonographic data were re-evaluated.ResultsThe mean age was 42 years. One patient was postmenopausal, and five patients were premenopausal. All of them had a complaint of meno-metrorrhagia. We re-evaluated preoperative sonographic images of patients, and defined 83.3% as well-defined margins, 66.7% hyperechoic, 100% heterogeneous, 66.7% non-cystic, 50% calcification and 66.7% acoustic shadowing. Pathologic features showed mean number of mitosis 8, mild atypia 66.7%, and necrosis 33.3%. In a 24-year-old unmarried female patient with myomectomy, we detected recurrance of tumor in sonographic and MRI studies after 11 months, and confirmed the diagnosis via tru-cut biopsy. There was no relevance between sonographic findings and atypia, necrosis and mitosis. The recurrence was not in relationship with mitosis, degree of atypia and necrosis. We found no relevance between tumor diameter and mitosis, atypia, necrosis and recurrence.ConclusionsSTUMP is classified as an intermediate form, histopathologically so calling it benign or malignant for sure is not possible. Singulary, solidity, hyperechogenicity, heterogenecity and features of acoustic shadowing and margins can guide us to preoperative sonographic diagnosis. Recurrence/metastasis after many years from operation can be seen, and those patients should be followed long term.

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The purpose of this study was to evaluate the effects of vitamin D supplementation on ovarian reserve markers, including serum anti-Mullerian hormone (AMH) level, follicle-stimulating hormone (FSH) level, and antral follicle count (AFC), in infertile women with diminished ovarian reserve and vitamin D deficiency.A prospective, nonrandomized, cross-sectional study was conducted. Women aged 18 to 41 years who were unable to become pregnant after 12 months of sexual intercourse and had normal tubal patency, partners with normal semen analysis, diminished ovarian reserve, and 25-hydroxyvitamin D [25(OH)D] deficiency were included. Eligible patients' AFC and serum levels of AMH, FSH, 25(OH)D, 1,25-dihydroxyvitamin D [1,25(OH)D], calcium, phosphate, alkaline phosphatase, and parathormone were assessed before and after administration of 300,000 IU of vitamin D ampules. Changes in the parameter values after vitamin D supplementation were compared with the initial levels.The study was conducted in 62 of the 142 participants. The AFC and AMH, 25(OH)D, 1,25(OH)D, phosphate (P < .01), and calcium levels (P < .05) were statistically significantly increased after vitamin D supplementation. Statistically significant decreases in FSH (P < .01) and alkaline phosphatase levels (P < .05) were observed after vitamin D supplementation. No statistically significant correlations were found between 25(OH)D level and AFC, 1,25(OH)D level, AMH level, and FSH level before and after supplementation (P > .05).As improvements in the ovarian reserve markers were obtained with vitamin D supplementation, vitamin D might be considered as a fertility treatment for patients with diminished ovarian reserve and vitamin D deficiency. Abbreviations: [1,25(OH)D] = 1,25-dihydroxyvitamin D, [25(OH)D] = 25-hydroxyvitamin D, AFC = antral follicle count, ALP = alkaline phosphatase, AMH = anti-Mullerian hormone, BMI = body mass index, COS = controlled ovarian stimulation, DOR = diminished ovarian reserve, FSH = follicle-stimulating hormone, IVF = in vitro fertilization, PCOS = polycystic ovary syndrome.

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