Uterine smooth muscle tumor of uncertain malignant potential: a three-case report

2008 ◽  
Vol 18 (5) ◽  
pp. 1121-1126 ◽  
Author(s):  
R. Berretta ◽  
M. Rolla ◽  
C. Merisio ◽  
G. Giordano ◽  
G. B. Nardelli

Based on the degree of cytologic atypia, mitotic activity, and other features, uterine smooth muscle tumors have historically been grouped into two classes: benign leiomyomas and malignant leiomyosarcomas. However, this separation holds true more in principle than in practice because the tumor's biological potential may not always be determined with certainty, complicating diagnosis, and therapy. We report three cases of patients with uterine smooth muscle tumors of uncertain malignant potential. Surgery was radical in two and conservative in one. During the follow-up, one patient developed diffuse lung metastases. The two other patients have not shown any signs of relapse to date. Uterine smooth muscle tumors of uncertain malignant potential may have an unpredictable clinical course and may metastasize to seemingly low-grade neoplasms in distant sites even after several years and even in the absence of important negative prognostic predictors, such as coagulative tumor cell necrosis. At present, no final consensus has been reached on the choice of the best strategy for surgery and adjuvant therapy

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 15028-15028 ◽  
Author(s):  
B. Pothuri ◽  
S. M. Kehoe ◽  
T. Wright ◽  
T. Herzog

15028 Background: Smooth muscle tumors of uncertain malignant potential (STUMP) and atypical leiomyomas have increased mitotic activity, cellular atypia and necrosis but the degree is less than that used to define uterine leiomyosarcomas. Our objective is to evaluate the clinical outcome of patients with uterine masses histologically defined as smooth muscle tumors of uncertain malignant potential or atypical leiomyomas. Methods: A thorough search of our institution’s pathology database from 1990 to 2005 was performed. A retrospective chart review was performed to obtain initial and subsequent treatments, documented recurrences and clinical outcomes. Pathology reports and slides were reviewed and the presence of atypia, necrosis and number of mitosis was recorded. Statistical analysis was performed by Student’s T-test. Results: Eighteen patients with a histologic diagnosis of atypical leiomyoma were identified with 14 STUMP, 2 bizarre leiomyomas, 1 myxoid and 1 mitotically active leiomyoma. The mean age of these patients was 41.8 years (range: 25–77) and was significantly younger than those with leiomyosarcoma (mean age was 54 years, p < 0.001). The histologic characteristics of the tumors included the presence of atypia at 50%, necrosis at 82% and mitoses at 94%. The rate of necrosis and number of mitosis was significantly less in the atypical group as compared to the leiomyosarcoma group (p values < 0.05). However the rate of cellular atypia was not statistically different between the two groups. The median follow-up period was 25 months, range 1–138 months. One of the eighteen patients developed a pelvic and pulmonary recurrence at which time a low grade leiomyosarcoma was diagnosed. The recurrence occurred 32 months after the initial diagnosis of a mitotically active leiomyoma. Sixteen patients demonstrated no recurrence or metastatic disease at the time of follow-up. Conclusions: Atypical leiomyomas appear to be diagnosed in younger women which leads to challenging treatment issues involving fertility preservation. While these tumors generally behave in a benign fashion, they have histologic characteristics that may allow for progression or recurrence. Close follow-up is warranted for patients who are diagnosed with atypical leiomyomas and smooth muscle tumors of uncertain malignant potential. No significant financial relationships to disclose.


Author(s):  
Alpha Boubacar Conte ◽  
Jihad Jamor ◽  
Fatima Zohra Fdili Alaoui ◽  
Sofia Jayi ◽  
Hikmat Chaara ◽  
...  

Rarely diagnosed in authors department, uterine smooth muscle tumor of uncertain malignant potential (STUMP) is one of the histologic types of uterine sarcoma. Among women undergoing hysterectomy or myomectomy for a presumed diagnosis of leiomyoma, 0.01% receive a diagnosis of STUMP. Authors report a case occurring to a patient aged of 55 which was diagnosed, managed successfully and followed-up in authors department.


2020 ◽  
Vol 3 ◽  
Author(s):  
Boubacar Conte Alpha ◽  
Jebryl Elhaoudani ◽  
Mahomed Yessoufou ◽  
Hikmat Chaara ◽  
Moulay Abdelilah Melhouf

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