CASE REPORT OF FEMALE PATIENT WITH SMOOTH MUSCLE TUMOR OF UNCERTAIN MALIGNANT POTENTIAL
Keywords:uterine tumors, smooth muscle tumor of uncertain malignant potential
Smooth muscle tumors of uterus are usually categorized as benign leiomyomas or malignant leiomyosarcomas. Tumors not diagnosed unequivocally as benign or malignant should be defined as STUMP (smooth muscle tumor of uncertain malignant potential). In other words, it is a subgroup of uterine neoplasms that is rare and without standardized protocols yet, which makes it a true challenge for a physician. The reasons why patients seek medical help are heavy and irregular bleeding from the uterus with consequent anemia, dysmenorrhea, dyspareunia, pain in the pelvis or lower abdomen, abdominal distension, compressive symptoms such as urinary problems or constipation, and infertility. Fertility-sparing surgery is recommended for patients who have not given birth and wish to preserve fertility, while total hysterectomy with or without bilateral salpingo-oovariectomy is recommended for patients who do not plan further pregnancies.
Parker WH. Uterine fibroids. U: Berek JS. Berek & Novak's Gynecology. 16th edition. Philadelphia: Wolters Kluwer; 2020. str. 223-250.
Dall'Asta A, Gizzo S, Musarò A, Quaranta M, Noventa M, Migliavacca C, Sozzi G, Monica M, Mautone D, Berretta R. Uterine smooth muscle tumors of uncertain malignant potential (STUMP): pathology, follow-up and recurrence. Int J Clin Exp Pathol. 2014 Oct 15;7(11):8136-42. PMID: 25550862; PMCID: PMC4270570.
Kertowidjojo EC, Bennett JA. Update on Uterine Mesenchymal Neoplasms. Surg Pathol Clin. 2022 Jun;15(2):315-340. doi: 10.1016/j.path.2022.02.008. Epub 2022 May 20. PMID: 35715164.
Devereaux KA, Schoolmeester JK. Smooth Muscle Tumors of the Female Genital Tract. Surg Pathol Clin. 2019 Jun;12(2):397-455. doi: 10.1016/j.path.2019.02.004. PMID: 31097110.
. Di Giuseppe J, Grelloni C, Giuliani L, Delli Carpini G, Giannella L, Ciavattini A. Recurrence of Uterine Smooth Muscle Tumor of Uncertain Malignant Potential: A Systematic Review of the Literature. Cancers (Basel). 2022 May 7;14(9):2323. doi: 10.3390/cancers14092323. PMID: 35565452; PMCID: PMC9104240.
Angiolo Gadducci, Gian Franco Zannoni. Uterine smooth muscle tumors of unknown malignant potential: A challenging question. Gynecologic Oncology.Volume 154, Issue 3, 2019,Pages 631-637.
Liu HT, Wong CN, Wong CN, Liu FS. Uterine smooth muscle tumor of uncertain malignant potential: A review of current knowledge. Taiwan J Obstet Gynecol. 2022 Nov;61(6):935-940. doi: 10.1016/j.tjog.2022.08.003. PMID: 36427995.
Delgado, Bertha M.D.; Dreiher, Jacob M.D., M.P.H., Ph.D.; Braiman, Dana M.D.; Meirovitz, Mihai M.D.; Shaco-Levy, Ruthy M.D.. P16, Ki67, P53, and WT1 Expression in Uterine Smooth Muscle Tumors: An Adjunct in Confirming the Diagnosis of Malignancy in Ambiguous Cases. International Journal of Gynecological Pathology 40(3):p 257-262, May 2021.