Uterine Smooth Muscle Tumor of Uncertain Malignant Potential: Clinicopathologic-Sonographic Characteristics, Follow-Up and Recurrence

Abstract

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.

Oncologic and Reproductive Outcomes of Uterine Smooth Muscle Tumor of Uncertain Malignant Potential: A Single Center Retrospective Study of 67 Cases

“…According to the limited statistics, STUMP is generally found in younger aged women than other tumors of the uterus. In this study, the median age of patients was 42 years, similar to previously reported cases (6)(7)(8)(9)(10)(11)(12). Since the patients are young, preserving fertility is an essential consideration in the selection of treatment.…”

Uterine smooth muscle tumours of uncertain malignant potential: single-centre experience and review of the literature

“…STUMP is diagnosed more often in premenopause, at an average age of 44 years. As seen in our cohort of patients, the most frequent chief complaint, leading to surgery and postoperative diagnosis of STUMP, is heavy menstrual bleeding with or without development of anaemia [5]. The clinical presentation of STUMP does not differ from other SMTs such as leiomyoma or leiomyosarcoma -pelvic pain, pelvic mass, abnormal uterine bleeding, compression of adjacent organs and secondary anaemia, infertility, dysmenorrhoea, and abnormal vaginal discharge may all be present [6][7][8][9][10], thus rendering non-specific symptoms in all these histologically and clinically different conditions.…”

Disseminated Peritoneal Leiomyomatosis with Atypical Features and Comorbid Uterine STUMP: a Case Report and Review of the Literature

“…Therefore, it is hard to predict the biological behavior, metastatic potential, or prognosis of STUMP. Reported survival outcome is good, with a five-year survival rate of 92-100% (15). In summary, we described a rare manifestation of DPL with atypical features and comorbid uterine STUMP, stable at the 20-month follow-up after the surgery.…”