Incidental Prostatic Stromal Tumor of Uncertain Malignant Potential                     (STUMP): Histopathological and Immunohistochemical Findings

Stromal prostate tumors are rare neoplastic proliferative lesions that have been classified into prostatic stromal tumor of uncertain malignant potential (STUMP) and prostatic stromal sarcoma (SS) based on these criteria: stromal cellularity, presence of mitotic figures, necrosis, and stromal overgrowth. A prostatic stromal tumor of uncertain malignant potential (STUMP) is a non-epithelial, mesenchymal spindle-cell tumor that can be classified as a specialized stromal tumor of the prostate. STUMPs have the capability to diffusely infiltrate the prostate gland and extend into adjacent tissues. Furthermore, they often recur and this is why they are considered as neoplastic entities. STUMPs usually tend to be not aggressive, but occasional cases have been reported with an extension into adjacent tissues. A few cases develop a sarcomatous dedifferentiation. A 67-year-old male referred to the Department of Urology, Sapienza Rome University, with acute urinary retention (AUR) and bladder overdistention. Digital rectal examination (DRE) showed the presence of a severe prostatic hyperplasia and a transvesical prostatic adenomectomy (TVPA) was performed. The pathological evaluation performed at the Department of Pathology, Sapienza Rome University, revealed an incidental diagnosis of prostatic STUMP. The patient's follow-up is made every year with transrectal ultrasonography and nuclear magnetic resonance with spectroscopy, and every two years with a transperineal prostate biopsy to exclude a progression to a stromal sarcoma. After 5 years of follow-up the STUMP is still detectable but there is no sign of sarcoma. As a result of its relative rarity and lack of long-term follow-up, the prognosis of STUMP is unclear. Therapy varies from a wait-and-see approach to a radical retropubic prostatectomy.

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Prostatic Stromal Tumor of Uncertain Malignant Potential Which Was Difficult to Diagnose

Case Reports in Urology ◽

10.1155/2015/879584 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5

Author(s):

Satoko Matsuyama ◽

Takahiro Nohara ◽

Shohei Kawaguchi ◽

Chikashi Seto ◽

Yuko Nakanishi ◽

...

Keyword(s):

Transurethral Resection ◽

Digital Rectal Examination ◽

Radical Resection ◽

Final Diagnosis ◽

Malignant Potential ◽

Stromal Tumor ◽

Prostatic Urethra ◽

Uncertain Malignant Potential ◽

Stromal Sarcoma ◽

Stromal Tissue

Here, we report a case of stromal tumor of uncertain malignant potential (STUMP) that was difficult to diagnose. A 53-year-old male was found to have a hard nodule on digital rectal examination; magnetic resonance imaging revealed a large nodule on the left side of the prostate, indicating prostate cancer. However, pathological diagnosis of the biopsy specimen was benign prostatic hyperplasia. Although a papillary tumor in the prostatic urethra was also seen on urethrocystoscopy, the tumor specimen obtained from transurethral resection was not malignant. The tumor in the prostatic urethra recurred only 3 months after transurethral resection, and pathological findings revealed benign hyperplasia not only in the stromal tissue but also in the epithelium; therefore, the prostate tumor was suspected to be STUMP. It took many prostate pathologists a long time to reach the final diagnosis of STUMP. STUMP is a rare benign tumor, difficult to diagnose, and sometimes transforms into stromal sarcoma. Thus, we should consider radical resection in such cases.

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Clinical and Pathological Features of Prostatic Stromal Tumor of Uncertain Malignant Potential: A Retrospective Study of 23 Chinese Cases

Urologia Internationalis ◽

10.1159/000508763 ◽

2020 ◽

pp. 1-9

Author(s):

Qi Shen ◽

Zhaohui Zhou ◽

Zhenhua Liu ◽

Shuai Hu ◽

Zhiyong Lin ◽

...

Keyword(s):

Disease Progression ◽

Rare Disease ◽

Subgroup Analysis ◽

Specific Antigen ◽

Malignant Potential ◽

Stromal Tumor ◽

Uncertain Malignant Potential ◽

Stromal Sarcoma ◽

The Mean

Introduction: Prostatic stromal tumor of uncertain malignant potential (STUMP) is a rare disease that may coexist with prostate stromal sarcoma (PSS). We aimed to analyze the histological and clinical features of STUMP. Methods: Twenty-three patients diagnosed with STUMP from 2008 to 2019 were included. Clinicopathological and follow-up information was collected. In the subgroup analysis, we divided the patients into a pure STUMP group (N = 18) and a mixed STUMP (STUMP coexisting with PSS) group (N = 5). Student’s t test was used to compare the 2 groups. Results: Patients had a mean age of 55.5 ± 19.4 years and an average follow-up time of 42.3 months. The mean prostate volume was 109.2 ± 73.5 cm3, and the mean prostate-specific antigen was 8.03 ± 10.5 ng/mL. In the subgroup analysis, 16.7% (2/12) of pure STUMP patients had disease progression, while 100% (3/3) of mixed STUMP patients suffered from recurrence. Compared with the pure STUMP group, the mixed STUMP group was younger (37.2 vs. 60.6 years, p = 0.013) and had lower expression of estrogen receptor and progesterone receptor (p = 0.004 and p < 0.001, respectively). Conclusion: STUMP is a rare disease with a relatively good prognosis. However, there is still a possibility of disease progression or coexistence with stromal sarcoma. Timely diagnosis and regular monitoring may be helpful in improving treatment outcomes.

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Prostate Stromal Tumor of Uncertain Malignant Potential: Case Report With 5-Year Follow-up

Urology Case Reports ◽

10.1016/j.eucr.2014.01.008 ◽

2014 ◽

Vol 2 (2) ◽

pp. 43-44 ◽

Cited By ~ 1

Author(s):

Abdo E. Kabarriti ◽

Thomas J. Guzzo ◽

Alan J. Wein

Keyword(s):

Case Report ◽

Malignant Potential ◽

Stromal Tumor ◽

Uncertain Malignant Potential ◽

Potential Case

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Stromal Tumor of Uncertain Malignant Potential of the Prostate

Archives of Pathology & Laboratory Medicine ◽

10.5858/arpa.2013-0212-rs ◽

2014 ◽

Vol 138 (11) ◽

pp. 1542-1545 ◽

Cited By ~ 11

Author(s):

Lauren M. Murer ◽

Geoffrey A. Talmon

Keyword(s):

Aggressive Behavior ◽

Distant Metastasis ◽

Surgical Intervention ◽

Clinical Course ◽

Malignant Potential ◽

Stromal Tumor ◽

Rare Tumor ◽

Uncertain Malignant Potential ◽

Stromal Sarcoma

Stromal tumor of uncertain malignant potential (STUMP) of the prostate is a rare tumor with a variable and unpredictable clinical course. Many STUMPs are diagnosed incidentally and never progress, while others may invade locally and rapidly recur after surgical intervention, and yet others may lead to distant metastasis and death. A wide array of histologic patterns is encompassed by STUMP, and distinguishing these tumors from prostatic stromal sarcoma or other causes of stromal expansion often proves difficult. Owing to the rarity of this tumor, there is not yet a consensus on appropriate management. However, owing to the possibility of aggressive behavior, close management and consideration of definitive resection is warranted.

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Recurrent Prostatic Stromal Tumor of Uncertain Malignant Potential Combined with Concurrent Prostatic Adenocarcinoma: An Unusual Case

Urologia Internationalis ◽

10.1159/000511652 ◽

2021 ◽

pp. 1-5

Author(s):

Zhen Zhang ◽

Chaozhao Liang

Keyword(s):

Transurethral Resection ◽

Unusual Case ◽

Malignant Potential ◽

Prostatic Adenocarcinoma ◽

Stromal Tumor ◽

Simultaneous Occurrence ◽

Uncertain Malignant Potential ◽

Unique Case ◽

Neoplastic Lesions

Prostatic stromal tumor of uncertain malignant potential (STUMP), characterized by an atypical, unique stromal proliferation of the prostate, is often difficult to be differentiated from other nonepithelial neoplastic lesions. We present a unique case of recurrent STUMP after transurethral resection of the prostate (TURP) with concurrent prostatic adenocarcinoma. Patients diagnosed with prostatic STUMP should be followed up closely, for it may recur and invade adjacent organs after TURP shortly. Concurrent prostatic adenocarcinoma can be found in STUMP patients, and there may be some potential mechanisms which promote the simultaneous occurrence of the 2 tumors.

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Minimally invasive treatment options to borderline ovarian tumors

10.1055/s-0039-1685392 ◽

2016 ◽

Author(s):

Punita Bhardwaj ◽

T. K. Das ◽

S. Batra ◽

Keyword(s):

Early Stage ◽

Treatment Options ◽

Malignant Potential ◽

Ovarian Tumors ◽

Conservative Approach ◽

Uncertain Malignant Potential ◽

Invasive Treatment ◽

Younger Women ◽

Borderline Ovarian Tumors

Borderline Ovarian tumors are tumors of uncertain malignant potential. They have favour able prognosis. They occur in younger women and present at an early stage. They are difficult to diagnose preoperatively as macroscopic picture is a combination of benign and invasive ovarian tumors. Over the years surgical treatment has changed from radical to conservative approach without overlooking oncologic safety. Follows up is essential. Prolonged follow up (>10 yrs) is required because of later recurrences. Special attention is to be paid to the conserved ovary in follow up.

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